# Homologous recombination deficiency (HRD) score predicts response to platinum-containing neoadjuvant chemotherapy in patients with triple-negative breast cancer

Source: https://onco.cc/key-papers/paper-telli-hrd-score-platinum-tnbc-ccr-2016/  
OnCo record `paper-telli-hrd-score-platinum-tnbc-ccr-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A genome-scar score built from three measures of chromosomal damage, with 42 as the cut-off, picked out triple-negative tumours that melted away on platinum chemotherapy before surgery, including tumours without a BRCA mutation.

## Summary

A combined HRD score, the unweighted sum of loss of heterozygosity, telomeric allelic imbalance and large-scale state transition scores, was assessed in three neoadjuvant TNBC trials of platinum-containing therapy, with HR deficiency defined as HRD score 42 or more or BRCA1/2 mutation. In the platinum, gemcitabine and iniparib trial HR deficiency predicted residual cancer burden 0/I and pathological complete response (OR 4.96 and 6.52), remaining significant after clinical adjustment (OR 5.86); in two cisplatin trials it predicted RCB 0/I and pCR (OR 10.18 and 17.00; multivariable OR 12.08). Among BRCA1/2 non-mutated tumours response was higher with high HRD scores.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Clinical Cancer Research
- Year: 2016
- DOI: 10.1158/1078-0432.CCR-15-2477
- Authors: Telli ML, Timms KM, Reid J, et al.
- Findings: HR deficiency (HRD score 42 or more or BRCA1/2 mutation) predicted RCB 0/I and pCR in three platinum trials (OR 4.96 to 17.00).; The association held in BRCA1/2 wild-type tumours with high scores.; The 42 threshold later became the myChoice CDx cut-off in ovarian cancer.
- What it means: This paper set the HRD score threshold the myChoice assay still uses and showed that genomic scars extend platinum sensitivity beyond BRCA carriers in early TNBC, though the TNT trial later found the same score did not predict carboplatin benefit in advanced disease.
- Caveats: Three small single-arm or phase 2 trials; response, not survival, endpoints.; Predictive of platinum response, not of benefit over non-platinum chemotherapy.

## Sources

- Telli et al., Clin Cancer Res 2016: HRD score predicts platinum response in three neoadjuvant TNBC trials: https://doi.org/10.1158/1078-0432.CCR-15-2477
- PubMed: https://pubmed.ncbi.nlm.nih.gov/26957554/

## Connected records

- cancers: [Early triple-negative breast cancer](https://onco.cc/cancers/tnbc-early/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [HRD & BRCA testing](https://onco.cc/technologies/hrd-testing/), [HRD genomic scar scores (GIS, LOH, HRDetect)](https://onco.cc/technologies/hrd-genomic-scar-scores/), [Platinum agents](https://onco.cc/technologies/platinum/)
- targets: [BRCA1 / BRCA2 (HRD)](https://onco.cc/targets/brca/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [myChoice CDx](https://onco.cc/drugs/mychoice-cdx/)
- companies: [Myriad Genetics](https://onco.cc/companies/myriad-genetics/)
- terms: [Homologous recombination deficiency (HRD)](https://onco.cc/terms/hrd/), [Pathologic complete response (pCR)](https://onco.cc/terms/pcr/), [Residual cancer burden (RCB)](https://onco.cc/terms/rcb/)
- journals: [Clinical Cancer Research](https://onco.cc/journals/clinical-cancer-research/)
- biomarkers: [HRD-positive (genomic instability score)](https://onco.cc/biomarkers/hrd-positive/)

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