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PAOLA-1 HRD — SCE Medical Oncology MCQ

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HardGynaecological CancersPAOLA-1 HRDSCE Medical Oncology

A 62-year-old has FIGO stage IV high-grade serous ovarian cancer. After first-line carboplatin–paclitaxel with bevacizumab she has a partial response. Tumour testing is BRCA1/2 wild-type but shows genomic instability consistent with homologous-recombination deficiency. Which maintenance strategy is recommended by NICE for this exact setting?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Olaparib with continued bevacizumab maintenance

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

A is correct: TA946 includes BRCA-wild-type tumours when HRD is established by genomic instability, provided the cancer responded to first-line platinum chemotherapy with bevacizumab. B omits continued bevacizumab from the TA946 regimen; C ignores the HRD-positive indication; D substitutes niraparib for olaparib; E is wrong because partial as well as complete response qualifies.

Reference: NICE TA946 olaparib with bevacizumab: recommendations (Published 17 January 2024): https://www.nice.org.uk/guidance/ta946/chapter/1-Recommendations