Fig. 3.

Clinical pathway for therapy choice in MOC. We suggest that high-risk disease (grade 3/advanced stage/infiltrative subtype) should be pre-emptively tested for genomic events using a suitable panel method, since these are unlikely to respond completely to the adjuvant chemotherapy that will be offered while genomic testing is performed. On recurrence of non-high risk disease, genomic testing should also be performed, preferably on recurrence tumor tissue if this is available through surgical debulking or biopsy. If not, primary tumor tissue could be used. ER, estrogen receptor; HRD, homologous recombination deficiency; TMB, tumor mutational burden; “i”, inhibitor. TKi, tyrosine kinase inhibitor.