Given more restrictions on later line PARP inhibitor use for patients by BRCA status, would you consider repeat biopsy with somatic testing to identify candidates for second line maintenance therapy following platinum treatment for a patient who is gBRCAwt?
Does your approach change depending on the patients initial somatic BRCA status?
Answer from: at Academic Institution
I would be comfortable deciding on the use of PARP maintenance in the second line based on initial somatic testing and would not feel a need to rebiopsy. Additionally, olaparib still has an indication for BRCAwt patients for maintenance post frontline regardless of biomarker status.
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Answer from: Medical Oncologist at Academic Institution
In practice at my institution, we often re-biopsy at the time of recurrence and order testing such as Foundation One (whole exome sequencing, microsatellite instability assessment, tumor mutational burden) in women with gynecological malignancies to evaluate for clinical trials and for therapeutic o...