Quiz for High Grade Ovarian Cancer (Part 2): BRCA, Genetics and PARP Inhibitors

Last updated on Apr 1, 2025

Question 1: Which of the following genetic alterations is most commonly associated with homologous recombination deficiency in high-grade serous ovarian cancer?

A. PALB2 mutation

B. TP53 mutation

C. BRCA1 mutation

D. KRAS mutation

Question 2: A patient with high-grade serous ovarian carcinoma is found to have a somatic BRCA2 mutation. Which of the following statements best describes the clinical implication?

A. She should undergo cascade testing of family members.

B. She is ineligible for PARP inhibitors.

C. The mutation is present in all her body cells.

D. Her tumor is likely sensitive to PARP inhibitors.

Question 3: Which of the following is the primary mechanism by which PARP inhibitors cause tumor cell death in BRCA-mutated ovarian cancer?

A. Apoptosis via p53 activation

B. Inhibition of angiogenesis

C. Inhibition of homologous recombination

D. Synthetic lethality

Question 4: Which of the following groups derives the greatest overall survival benefit from PARP inhibitor maintenance therapy?

A. HRD-negative patients

B. HRD-positive, BRCA wild-type patients

C. BRCA-mutated patients

D. All epithelial ovarian cancer patients

Question 5: Which of the following genetic tests is FDA-approved for determining HRD status in ovarian tumors?

A. Tempus NGS

B. FoundationOne CDx

C. Myriad myChoice CDx

D. Caris Molecular Intelligence

Question 6: What is the most appropriate genetic counseling recommendation for a patient newly diagnosed with high-grade serous ovarian carcinoma?

A. Only test if there's a family history of cancer

B. Defer testing until recurrence

C. Refer all patients for genetic counseling and germline testing

D. Test tumor tissue only

Question 7: What is the approximate proportion of epithelial ovarian cancer patients with homologous recombination deficiency (HRD) based on current estimates?

A. 10%

B. 25%

C. 50%

D. 75%

Question 8: A patient receiving PARP inhibitors for maintenance therapy develops pancytopenia. Which of the following serious adverse effects must be considered in the differential diagnosis?

A. Lymphoma

B. Acute myeloid leukemia

C. Osteonecrosis

D. Hypothyroidism

Question 9: A 62-year-old woman is diagnosed with stage IIIC high-grade serous ovarian carcinoma after undergoing optimal cytoreductive surgery. Her tumor sequencing reveals a BRCA1 germline mutation. She has completed 6 cycles of adjuvant carboplatin and paclitaxel. She is now in clinical remission. Which of the following is the most appropriate next step in her management?

A. Begin bevacizumab maintenance for 12 months

B. Begin olaparib maintenance therapy for 2 years

C. Observe without maintenance

D. Enroll in clinical trial of immune checkpoint inhibitors

Question 10: A 58-year-old woman with newly diagnosed high-grade serous ovarian carcinoma undergoes genetic testing. She is found to have a tumor-only BRCA2 mutation but negative germline testing. She is currently completing her chemotherapy and is being considered for maintenance therapy. She asks whether her family members should be tested. What is the most appropriate counseling point regarding her BRCA mutation?

A. Tumor BRCA mutations are always germline and inherited

B. Family members should undergo BRCA testing immediately

C. Somatic mutations are not inherited; no familial testing is indicated

D. Further evaluation is needed to confirm germline vs somatic status