Jorge S, McFaddin AS, Doll KM, et al. - As in routine practice only germline testing is pursued or reimbursed at diagnosis despite the predictive value of both germline and somatic BRCA1 and BRCA2 (BRCA) mutations for treatment response in patients with epithelial ovarian, peritoneal or fallopian tube cancer (OC), researchers sought to report their experience with clinical testing of paired tumor and germline DNA for OC mutations. The medical records of 43 women (36 new diagnoses, seven recurrences) in whom simultaneous sequencing using the BROCA assay of DNA from paired blood and neoplastic tissue was undertaken were retrospectively reviewed. Half of ovarian cancer cases exhibited potentially actionable mutations: 14% germline, 35% somatic, and 2% both. Among all actionable mutations identified, pathogenic BRCA1 and BRCA2 mutations accounted for 59%. In one-fourth of new diagnoses and in one-half of recurrences, sequencing results directly impacted clinical care. These findings suggest the efficiency of simultaneous germline and tumor sequencing in providing enhanced information to guide the care of OC patients. This approach can lead to recognition of somatic BRCA mutations at diagnosis, supporting physicians to implement PARP inhibitor maintenance and improve outcomes for those patients.