Innovative Local Testing for Ovarian Cancer in Morocco
In a groundbreaking development for cancer diagnostics, researchers at the National Institute of Oncology in Rabat, Morocco, have successfully demonstrated that homologous recombination deficiency (HRD) testing for advanced high-grade serous ovarian carcinoma (HGSOC) can be performed locally. This significant advancement eliminates the need to send samples to commercial laboratories abroad, thereby enhancing accessibility to critical diagnostic services within the country. The findings were detailed in a recent study published in Diagnostic Pathology, focusing on the real-world implementation and feasibility of a decentralized HRD testing platform in North Africa.
The study involved a cohort of 215 patients enrolled from March 2024 to March 2026, where the researchers utilized an in-house next-generation sequencing pipeline known as the Oncomine Comprehensive Assay Plus on formalin-fixed paraffin-embedded tumor tissue. Impressively, the average turnaround time for test results was approximately three weeks, showcasing not only the efficiency of local testing but also its potential to alleviate the logistical and financial burdens associated with centralized commercial assays.
Challenges and Insights from the Study
Despite the promising results, the study encountered challenges regarding quality control, with 57 out of 215 samples, or 26.5 percent, failing analysis. The majority of these failures were attributed to DNA degradation, accounting for 40 cases, which highlights the variability that can arise in decentralized workflows. The remaining failures were linked to small core needle biopsies that exhibited low tumor cellularity or extensive stromal fibrosis. The strict histopathological selection criteria required tumor cellularity of at least 20 percent and necrosis below 30 percent for samples to be accepted for HRD testing.
From the 158 evaluable patients, 87 (55.1 percent) tested positive for HRD. Among these, a substantial 57.5 percent were found to harbor BRCA1/2 mutations, while the remaining 42.5 percent were characterized as BRCA wild-type. Notably, HRD prevalence correlated with age, peaking at 69.4 percent in patients aged 50 to 59 years and decreasing to 32.1 percent for those aged 70 and older. Additionally, the study highlighted discrepancies between TP53 sequencing data and immunohistochemical testing, revealing that 19 out of 27 wild-type cases displayed aberrant p53 staining patterns, raising the overall rate of p53 abnormalities to 94.9 percent among the cohort.
The economic implications of the findings are particularly significant, as the cost of a single HRD test was reported to represent 37.1 percent of Morocco's annual GDP per capita, exceeding 400 percent of the monthly minimum wage. These figures underscore the challenges of accessing centralized commercial testing in low- and middle-income settings. The authors emphasize that local and decentralized testing represents a clinically viable solution in resource-limited environments, while advocating for improvements in pre-analytical tissue processing quality and comprehensive health-economic evaluations to ensure sustainable access to precision oncology across Morocco and similar countries.
It is essential to note that while the study outlines successful implementation at a single Moroccan institution, the results do not establish treatment outcomes. The focus remains on testing feasibility, failure modes, and molecular prevalence rather than the effectiveness of therapies guided by HRD testing.
As reported by bioengineer.org.
