NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test
About NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test
| Field | Value |
|---|---|
| Also Known As | HRD Panel, HRR Gene Panel, Homologous Recombination Repair Deficiency Panel, NGS HRR Panel |
| Sample Type | FFPE tumour tissue block (formalin-fixed paraffin-embedded tissue) and peripheral blood (EDTA) |
| Fasting Required | No fasting required |
| Report Time | 30 days |
| Recommended For | Adults diagnosed with ovarian, breast, pancreatic, or prostate cancer where targeted therapy guidance is needed |
| Price | Starting at ₹28,000 |
What Is an NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test?
The NGS homologous recombinant deficiency panel (HRD panel) test is a specialised molecular test that analyses tumour tissue using next-generation sequencing (NGS) technology. It detects mutations across 28 genes involved in the body's DNA repair mechanism, known as the homologous recombination repair (HRR) pathway. When this pathway fails, cells cannot fix DNA damage effectively, a state called homologous recombination deficiency (HRD).
Doctors use this test to guide treatment decisions, particularly to assess whether a patient may benefit from targeted therapies. It is also known as the HRD panel, HRR gene panel, homologous recombination repair deficiency panel, or NGS HRR panel.
What Does an NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test Measure?
The test examines 28 genes and calculates a genomic instability score (GIS). Each gene plays a role in how cancer cells develop and how they may respond to treatment. Below is a summary of the genes tested and their purpose:
| Gene(s) | Purpose |
|---|---|
| BRCA1, BRCA2 | Primary genes linked to hereditary breast and ovarian cancer; mutations guide PARP inhibitor eligibility |
| ATM | Signals DNA damage; mutations account for a significant proportion of hereditary breast cancer cases |
| BARD1 | Works alongside BRCA1 in DNA repair; mutations raise cancer susceptibility |
| BRIP1 | A known breast cancer susceptibility gene involved in HRR |
| CDK12 | Part of DNA damage response; mutations linked to prostate and ovarian cancers |
| CHEK1, CHEK2 | Cell cycle checkpoint genes; mutations associated with increased breast cancer risk |
| FANCD2, FANCL | Fanconi anaemia pathway genes critical for repairing DNA crosslinks |
| KRAS | Oncogene involved in cell signalling; mutations influence therapy response |
| MRE11, NBN, RAD50 | Together form the MRN complex, essential for detecting and repairing DNA strand breaks |
| PALB2 | Partners with BRCA1 and BRCA2 directly in homologous recombination repair |
| PIK3CA | Involved in cell growth signalling; mutations affect targeted therapy selection |
| POLD1, POLE | DNA polymerase genes that maintain replication accuracy |
| PPP2R2A | Tumour suppressor gene involved in regulating the cell cycle |
| PTEN | Tumour suppressor gene; mutations are associated with multiple cancer types |
| RAD51, RAD51B, RAD51C, RAD51D, RAD52, RAD54L | A family of genes that coordinate DNA strand exchange during HRR |
| TP53 | A key tumour suppressor; among the most frequently altered genes in HRD-positive cancers |
| XRCC2 | DNA repair gene with a direct role in homologous recombination |
The test also calculates a genomic instability score (GIS), which measures three genomic markers: loss of heterozygosity (LOH), telomeric allelic imbalance (TAI), and large-scale state transitions (LST). Together, these determine whether the tumour is HRD-positive or HRD-negative.
Why Is an NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test Done?
This test is ordered when an oncologist needs to understand the genetic characteristics of a tumour to choose the most suitable treatment.
Common Symptoms That May Require This Test
A doctor may recommend this test based on a patient's diagnosis or clinical situation, rather than specific symptoms. The following situations commonly lead to a referral for this test:
- Confirmed diagnosis of high-grade ovarian, fallopian tube, or peritoneal cancer
- Diagnosis of triple-negative breast cancer
- Advanced or metastatic prostate cancer under evaluation for targeted therapy
- Diagnosis of pancreatic cancer where platinum-based treatment is being considered
- Strong family history of BRCA-related cancers
- Assessment for eligibility for PARP inhibitor therapy
- Cancer recurrence after prior platinum-based chemotherapy
Conditions This Test Can Help Detect
This panel helps identify specific tumour characteristics that guide treatment decisions. It is relevant for the following:
- Homologous recombination deficiency in high-grade serous ovarian cancer
- BRCA1 and BRCA2 somatic mutations in breast, ovarian, pancreatic, and prostate cancers
- Eligibility for PARP inhibitor therapy (such as olaparib, niraparib, or rucaparib)
- Tumours likely to respond to platinum-based chemotherapy
- Hereditary cancer syndrome markers that may warrant confirmatory germline testing
How to Prepare and What to Expect
No special preparation is required for the NGS homologous recombinant deficiency panel test procedure. However, the sample collection process involves tumour tissue, so some planning with your healthcare team is necessary.
Do You Need to Fast?
No, fasting is not required. This test uses tumour tissue, not a routine blood sample, so food and drink do not affect the sample quality. Always follow specific instructions provided by your doctor.
Practical Tips Before Your Test
The following steps will help ensure the sample is suitable for testing:
- Confirm with your oncologist whether tissue from a previous biopsy or surgery can be used; archived FFPE tissue blocks are often acceptable
- Ensure the FFPE tissue block has at least 20% tumour content and is accompanied by a histopathology (HPE) report and an immunohistochemistry (IHC) report
- Inform your doctor about all previous biopsies, surgeries, or chemotherapy treatments
- Genetic counselling is recommended before and after testing to help interpret results in the context of your personal and family history
Step-by-Step Procedure
The sample collection process for this test involves two sample types: tumour tissue and peripheral blood. The steps below describe how each is collected and processed:
FFPE Tumour Tissue:
- A tumour tissue sample is obtained through a biopsy or during surgery, typically at or before the point of diagnosis.
- The tissue is fixed and embedded in paraffin to create an FFPE block, which is sent to the laboratory.
- DNA is extracted from the block and prepared into sequencing libraries with quality markers.
Peripheral Blood:
- A trained phlebotomist collects 2 ml of blood from a vein in your arm into a lavender-top EDTA tube. This step is brief and causes minimal discomfort.
- Both samples are stored under refrigeration (2 to 8°C) and dispatched to the laboratory.
- The laboratory performs NGS sequencing, analyses the 28 genes, calculates the GIS, and prepares a report for your oncologist within 30 days.
Factors That Can Affect Accuracy
- Low tumour content in the tissue block
- High levels of necrotic tissue in the sample
- Poor fixation of the tissue during initial processing
- Prior chemotherapy, which can alter genomic instability patterns
- Inadequate sample volume or degraded DNA due to storage issues
- Technical quality of the sequencing library
Understanding Your NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test Results
Results from the NGS homologous recombinant deficiency panel (HRD panel) test are reported as HRD-positive or HRD-negative, along with individual gene mutation classifications. Your oncologist or a molecular geneticist will review the findings alongside your clinical history. The table below outlines how results are generally classified:
| Category | Result / Type | Interpretation |
|---|---|---|
| HRD Status | HRD-Positive | DNA repair deficiency present; may respond to PARP inhibitors and platinum therapy |
| HRD Status | HRD-Negative | No significant DNA repair deficiency detected; lower expected response to PARP inhibitors |
| Genomic Instability Score (GIS) | ≥ 42 (HRD-Positive) | High genomic instability indicating defective DNA repair |
| Genomic Instability Score (GIS) | < 42 (HRD-Negative) | Low genomic instability; DNA repair likely intact |
| Gene Mutations | Pathogenic | Disease-causing variant with clinical significance |
| Gene Mutations | Likely Pathogenic | Probably disease-causing; strong evidence but not definitive |
| Gene Mutations | VUS (Variant of Uncertain Significance) | Genetic variant with unclear impact due to insufficient evidence |
| Gene Mutations | Benign | Not disease-causing; normal genetic variation |
Disclaimer: These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can affect how results are interpreted:
- Prior chemotherapy treatment may alter genomic instability patterns in the tumour, potentially reducing the accuracy of the HRD or GIS score.
- Samples with less than 20% tumour cells may produce inconclusive results or fail quality control screening.
- In some cases, tumours that initially showed HRD may regain repair function during treatment, which can affect both PARP inhibitor response and the reliability of re-testing.
- Necrotic or poorly fixed tissue may not yield sufficient DNA for valid sequencing.
How to Maintain Healthy Levels
While this test is not about routine wellness monitoring, the following steps can support informed decision-making:
- Consider genetic counselling to understand inherited cancer risks and whether family members should be tested.
- Follow your oncologist's recommended cancer screening schedule based on your diagnosis and test findings.
- Discuss all treatment options with your medical team, as HRD status is only one part of a broader treatment evaluation.
Lupin Diagnostics NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test Price
The NGS homologous recombinant deficiency panel test cost starts at ₹28,000 at Lupin Diagnostics. This test requires a visit to a Lupin Diagnostics centre; home collection is not available for this test due to the specialised nature of the sample requirements. The table below shows indicative prices:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 28000 |
| CHENNAI | 28000 |
| HYDERABAD | 28000 |
| KOLKATA | 28000 |
| NAVI MUMBAI | 28000 |
| PUNE | 28000 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample submission or coordinate tissue block dispatch with your treating hospital.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
The NGS homologous recombinant deficiency panel (HRD panel) test is used to assess whether a tumour has defects in its DNA repair system. This helps oncologists determine whether a patient is likely to respond well to targeted therapies like PARP inhibitors or platinum-based chemotherapy.
Patients diagnosed with advanced ovarian, triple-negative breast, pancreatic, or prostate cancer are the primary candidates. It is especially relevant when an oncologist is evaluating eligibility for targeted therapy or when a strong family history of BRCA-related cancers is present.
The test primarily requires an FFPE tumour tissue block from a biopsy or surgical procedure. The block must contain at least 20% tumour cells and should be accompanied by a histopathology report. A peripheral blood sample (2 ml in an EDTA tube) is also collected alongside the tissue.
At Lupin Diagnostics, the report is typically delivered within 30 days. The test results are delivered via email or WhatsApp.
An HRD-positive result indicates that the tumour's DNA repair system is impaired. This suggests the cancer cells may be particularly sensitive to PARP inhibitors, which exploit this repair defect to destroy cancer cells. Your oncologist will use this finding alongside other clinical factors to plan treatment.
This panel analyses somatic (tumour) DNA, not germline (inherited) DNA. While it may identify mutations that are also present in inherited DNA, a separate germline genetic test using a blood sample is needed to confirm hereditary cancer syndromes and to advise family members appropriately.
NGS Homologous Recombinant Deficiency Panel (HRD Panel) Test
