PARP inhibitor therapy was supported (LOE5B), though not received, in a patient with a malignant peripheral nerve sheath tumor, high HRD score (98.9th percentile in pediatric cohort), high SV burden (244; 93rd percentile in the pediatric cohort), and a somatic homozygous ATM mutation (p.F2839L), along with germline NF1 heterozygous loss of function mutation. This evidence concerns the gene NF1 and cancer.