HRD (Homologous Recombination Deficiency)

As these genes have extra-P-body functions, the score serves as a transcriptomic proxy for P-body component enrichment, not a direct measure of P-body activity. Despite this limitation, it offers a clinically useful tool for risk stratification and mechanistic hypotheses.

BRCA-associated pancreatic ductal adenocarcinomas demonstrate recurrent morphologic patterns, including increased glandularity, stromal hyalinization, myxoid stromal change and architectural heterogeneity. These observations provide a framework for future comparative studies investigating morphologic correlates of homologous recombination deficiency in pancreatic cancer. Recognition of these patterns may support consideration of germline or somatic DNA-repair gene testing in appropriate clinical settings.

In this study, testing contributivity was similar or higher that of other studies in the literature, and observed mutations prevalences were similar to that of other screenings of western populations. Harmonising per-centres protocols and enhancing molecular testing contributivity with the screening of circulating DNA samples and expanding its range by including non-BRCA HRR-related genes in all reference centres will enable more patients to be accurately treated by targeted therapies.

P2, N=30, Not yet recruiting, Danatlas Pharmaceuticals Co., Ltd

P2, N=120, Not yet recruiting, Shandong University

Due to limited germline and epigenetic data, MSI-H tumors could not be classified as Lynch-associated or sporadic. Overall, MSI-H and MSS CRCs in the Chinese population demonstrate distinct molecular landscapes in terms of TMB, HRD, EBV status, and driver gene alterations, underscoring the molecular heterogeneity of MSI-H CRC and the need for future studies integrating germline and epigenetic data to refine subtype classification.

One patient had a single brain metastasis and received comprehensive treatment including surgery, radiotherapy, chemotherapy, PD-1 inhibitor (tislelizumab), and PARP inhibitor (niraparib). The immune microenvironment characteristics of brain metastases (e.g., high PD-L1 expression, T-cell infiltration) may predict the efficacy of immunotherapy, but the prognosis for patients with multiple brain metastases remains poor. Further research is needed to explore the correlation between peripheral blood immune markers and treatment response in brain metastases.

In patients demonstrating substantial response to neoadjuvant chemotherapy (CRS 2-3), PARPi maintenance was associated with improved PFS, whereas no benefit was observed for CRS 1. The score may aid counseling regarding PARPi initiation, particularly in BRCA-wildtype patients or where homologous recombination deficiency (HRD) testing access is limited.

Functionally, ZMYM2 enhanced cisplatin tolerance, homologous recombination repair, and tolerance to DNA damaging treatments. However, both wild-type ZMYM2 and the K529R mutant restored platinum-resistant phenotypes in ZMYM2-knockdown cells, indicating that K529 lactylation primarily maintains ZMYM2 stability rather than directly determining its downstream pro-resistance activity. Collectively, these findings identify a glycolysis-lactate-ZMYM2 lactylation axis that promotes platinum resistance in ovarian cancer and highlight lactylation-dependent ZMYM2 stabilization as a potential therapeutic vulnerability.

Since the initial US Food Administration approval of olaparib in 2014, PARP inhibitors have shown efficacy across ovarian, breast, and prostate cancers, although differences in trial design and biomarker strategies have resulted in tumor-specific indications...Ongoing studies are evaluating rational combinations targeting complementary DNA damage response pathways (ATR/CHK1/WEE1, PI3K/AKT) and integrating immunotherapy or hormonal agents to extend benefit. Moving forward, harmonizing HRD testing across tumor types, accounting for germline, somatic, and liquid biopsy-derived alterations, and refining patient selection will be essential to maximize therapeutic efficacy and safely expand PARP inhibitor use beyond canonical BRCA-mutated cancers.

Therefore, support the potential utility of PARP inhibitors as molecularly targeted therapeutic alternatives to conventional chemotherapy in mutation-positive patients. Furthermore, the identification of novel population-specific variants underscores the urgent need for ethnicity-informed genetic screening protocols, facilitating earlier detection of hereditary risk and enabling informed treatment stratification in United Arab Emirates and Arab men with PCa.

Despite therapeutic advances, critical gaps persist in understanding how specific BRCA1/2 domains and residual protein activities contribute to tumorigenesis and treatment response. This review emphasizes the need for functional studies of BRCA1/2 variants to refine risk prediction and develop mutation-tailored therapies.