Biomarker-Driven Treatment Selection in Advanced Ovarian Cancer

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Leading gynecologic oncologists discuss comprehensive molecular testing strategies for patients with advanced ovarian cancer at ASCO 2025. Thomas C. Krivak, MD emphasizes the importance of upfront biomarker testing, including homologous recombination deficiency (HRD) testing, folate receptor testing, PD-L1 assessment, and HER2 evaluation. The panel stresses that combining germline and somatic testing provides crucial information for treatment planning while conserving precious tissue samples through comprehensive testing platforms.

The experts highlight the dramatic decrease in ovarian cancer cases to 20,000 annually, potentially attributed to increased genetic testing and preventive interventions. This reduction demonstrates the significant impact of identifying high-risk patients through BRCA and other hereditary cancer gene testing. The panelists emphasize that germline testing benefits not only patients but also their families by enabling risk assessment and preventive measures for relatives who may carry cancer-predisposing mutations.

Modern molecular testing approaches now integrate immunohistochemistry for HER2 and folate receptor with next-generation sequencing, streamlining the testing process. This comprehensive testing strategy guides treatment decisions for maintenance therapy, targeted treatments, and clinical trial eligibility. The discussion underscores how molecular profiling has revolutionized ovarian cancer management, moving from a one-size-fits-all approach to personalized, biomarker-driven treatment strategies that optimize patient outcomes.