![]() ![]() Here, we assessed the utility of an assay that reflects the current ability of tumors to perform HR. ![]() Moreover, RAD51-Low status predicted platinum sensitivity with 100% positive predictive value and was associated with better progression-free (HR, 0.53 95% CI, 0.33–0.85 P < 0.001) and overall survival (HR, 0.43 95% CI, 0.25–0.75 P = 0.003) than RAD51-High status. In a validation cohort, RAD51-Low tumors were more likely to be platinum-sensitive (RR, ∞ P < 0.001) than RAD51-High tumors. A novel automatic quantification system accurately reflected the manual assay (92%). The RAD51 score was predictive of chemotherapy response score [AUC, 0.90 95% confidence interval (CI), 0.78–1.0 P < 0.001). In a discovery cohort, RAD51-Low tumors were more likely to have a pathologic complete response (RR, 5.28 P < 0.001) and to be platinum-sensitive (RR, ∞ P = 0.05). Organoids from platinum-nonresponsive tumors had significantly higher RAD51 scores than those from platinum-responsive tumors ( P < 0.001). RAD51 scores correlated with in vitro response to platinum chemotherapy in established and primary ovarian cancer cell lines (Pearson r = 0.96, P = 0.01). ![]()
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