Defective DNA repair is one of the most important features of tumors. BRCA1/2 participates in homologous recombination repair as a key tumor suppressor gene. BRCA1/2 mutation is an important biomarker for predicting the sensitivity of platinum salts and Poly (ADP-ribose) polymerase (PARP) inhibitors in breast cancer, ovarian cancer, and other cancers. However, epigenetic modifications and other mutations in homologous recombination repair (HRR) genes can also cause homologous recombination deficiency (HRD). Patients with no BRCA1/2 mutations, but bearing similar molecular phenotypes (BRCAness) can still obtain clinical benefits from treatment with platinum salts or PARP inhibitors. Therefore, an accurate assessment of HRD is essential for the formulation of personalized treatments. However, methods to identify HRD in tumors vary and are controversial. Currently, genomic scar assays have been used in multiple clinical trials to assess patient clinical benefit. This review summarizes the therapeutic effects of platinum salts and PARP inhibitors in breast and ovarian cancer, clarifies the predictive value of genomic scar assays in evaluating the clinical benefit of different patient groups and treatment options, and proposes the limitations and optimization of current HRD scoring methods. Using and optimizing genomic scar assays can help to accurately screen the population with the most benefit, expand the scope of drug application, and make the most suitable clinical decision based on individual differences.

DNA缺陷修复是肿瘤最重要的特征之一。BRCA1 / 2作为重要的抑癌基因参与同源重组修复。BRCA1 / 2突变是预测铂盐和聚（ADP-核糖）聚合酶（PARP）抑制剂在乳腺癌，卵巢癌和其他癌症中敏感性的重要生物标志物。但是，同源重组修复（HRR）基因中的表观遗传修饰和其他突变也可能导致同源重组缺陷（HRD）。没有BRCA1 / 2的患者突变但具有相似的分子表型（BRCAness）仍可通过铂盐或PARP抑制剂的治疗获得临床益处。因此，对HRD的准确评估对于个性化治疗的制定至关重要。然而，在肿瘤中鉴定HRD的方法各不相同，并且存在争议。当前，基因组疤痕测定已用于多种临床试验中以评估患者的临床益处。这篇综述总结了铂盐和PARP抑制剂在乳腺癌和卵巢癌中的治疗作用，阐明了基因组疤痕测定在评估不同患者组和治疗方案的临床获益方面的预测价值，并提出了当前HRD评分方法的局限性和优化方法。