Clinical significance of homologous recombination deficiency score testing in endometrial Cancer

Jean H. Siedel, Kari L. Ring, Wei Hu, Robert L. Dood, Ying Wang, Keith Baggerly, Kathleen M. Darcy, Thomas P. Conrads, Shannon Gallagher, Placede Tshiaba, Chris Neff, Kirsten M. Timms, Selanere Mangala, Shannon N. Westin, Russell Broaddus, Gabriel Lopez-Berestein, Karen H. Lu, Robert L. Coleman, George L. Maxwell, Anil K. Sood*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Background: Homologous recombination deficiency (HRD) score is related to chemotherapy response in some cancers, but its role in endometrial cancer in not known. We determined frequency and clinical significance of alterations in the HR pathway in endometrial cancer. Methods: 253 endometrioid endometrial adenocarcinoma (EEA) samples from two independent cohorts (discovery and replication) were tested for HRD score using the Myriad HRD assay, microsatellite instability (MSI) and tumor mutation burden (TMB) using a next generation sequencing assay. HRD scores were also generated on endometrial cancer cell lines and in vivo response to olaparib was assessed. Results: ROC curves were employed to determine optimal cutoffs of HRD in relation to survival impact in endometrial cancer and a cutoff of HRD ≥ 4 was suggested for DFS using the discovery cohort. Patients from two independent cohorts with HRD score ≥ 4 trended toward worse survival as compared to those with HRD score < 4. Both cohorts were further separated into four groups according to molecular subtypes (TMB positive; MSI positive; HRD positive; all others). When grouped by molecular subtype, there was a significant difference between groups using an HRD ≥4 cutoff in the initial (p = 0.0024) and replication (p = 0.042) cohorts. The Hec1a model (HRD score = 19) was highly sensitive to olaparib in in vitro and in vivo experiments. Conclusions: High HRD score was associated with worse DFS in our patient cohort. These findings suggest that HRD score may have clinical utility in patients with advanced or recurrent endometrial cancer.

Original languageEnglish
Pages (from-to)777-785
Number of pages9
JournalGynecologic Oncology
Issue number3
StatePublished - Mar 2021
Externally publishedYes


  • BRCA1/2
  • HRD
  • PARP inhibitors
  • Platinum
  • Uterine cancer


Dive into the research topics of 'Clinical significance of homologous recombination deficiency score testing in endometrial Cancer'. Together they form a unique fingerprint.

Cite this