Oncologist-Initiated Genetic Testing Versus Genetics Referral for Ovarian Cancer Subtype
Posted: Wednesday, December 16, 2020
Germline BRCA mutations are found in as many as 15% of cases of high-grade serous ovarian, tubal, or peritoneal carcinoma; however, referrals to genetics specialists for testing can lead to delays in treatment. A pilot study by researchers from McGill University in Quebec, Canada, led by Xing Zeng, MD, investigated the use of gynecologic oncologist–initiated testing in patients with high-grade serous ovarian cancer. The results were published in the International Journal of Gynecological Cancer.
Patients diagnosed with high-grade serous ovarian, tubal, or peritoneal carcinoma were enrolled in the study after August 2017. They underwent testing from their oncologists for a panel of 13 genes, including BRCA1 and BRCA2. A group of patients who had been given traditional genetic counseling from January 2014 through August 2017 were also included as a control group. The primary study endpoint was genetic testing uptake in both groups; the secondary endpoint was the difference in time between diagnosis and genetic result.
The study comprised 152 women with high-grade carcinoma; 54 of the 108 patients (50.9%) in the control group were referred for genetic testing, whereas 39 of the 44 patients (86.2%) diagnosed in the year of the study received testing through their gynecologic oncologist. Pathogenic BRCA1 mutations were found in 5 (9.2%) control patients and 5 (13.1%) experimental patients, whereas 9 (16.7%) control patients and 3 (7.8%) experimental patients had mutations in BRCA2. There was a median time of 53 days between diagnosis to referral in the control group and 40 days in the experimental group. The median time from diagnosis to result disclosure was 58 days in the experimental group, a reduction of 128 days compared with the control, which was a median of 186 days (P < .01).
The researchers concluded: “Gynecologic oncologist-initiated genetic testing at the time of…diagnosis leads to increased uptake and decreased delays in testing compared with referral for traditional genetic counseling.”
Disclosure: The study authors reported no conflicts of interest.