Analytical Validation and Clinical Implementation of MedGenome HRD Assay: A Large Comparative Study Against Commercial HRD Assays in Ovarian Cancer

Background: Homologous recombination deficiency (HRD) is an important predictive biomarker for poly (ADP-ribose) polymerase inhibitor (PARPi) therapy in ovarian cancer (OC). However, real-world data on HRD prevalence and assay performance in Indian patients are limited. This study evaluated commercial HRD assays, then developed an in-house HRD assay and characterized HRD and BRCA alterations in a large real-world Indian OC cohort. Methods: This retrospective study included 4,163 formalin-fixed paraffin-embedded (FFPE) OC samples tested between 2021 and 2025. HRD and BRCA status were initially

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