Genetic Testing for Patients With Ovarian Cancers: Can Counseling Improve Decision-Making?
Posted: Wednesday, June 12, 2019
The development of oncologist-led BRCA1/2 mutation testing presents a feasible solution for patients diagnosed with ovarian, fallopian tube, and primary peritoneal cancers, according to results published in the Journal of Clinical Oncology. This streamlined BRCA1/2 mutation testing model may result in shorter turnaround times for patients by providing genetic testing and counseling, concluded Nicoletta Colombo, MD, of the University of Milan-Bicocca and the Istituto Europeo di Oncologia, Milan, and colleagues.
“Development of local [BRCA1/2 mutation] testing guidelines, involving oncologists, oncology nurses, and geneticists or genetic counselors and following a pathway similar to the one used in this study could allow faster treatment decisions and better use of resources in the management of patients with ovarian cancer,” the authors observed.
Theprospective, observational ENGAGE study evaluated this oncologist-led BRCA1/2 mutation testing pathway in 700 patients with ovarian cancer from 26 sites in the United States, Italy, and Spain as well 52 oncologists and 18 geneticists or genetic counselors. The authors assessed turnaround time and satisfaction of the process among all participants.
The median overall turnaround time for testing was 9.1 weeks, with more than 99% of patients reporting satisfaction before and after BRCA1/2 mutation test counseling. Among oncologists, more than 80% agreed that the process worked well and that counseling patients undergoing testing was an efficient use of their time. Oncologists expressed higher levels of satisfaction with the testing process than geneticists or genetic counselors.
“Strategies are needed to meet the growing demand for genetic testing,” the authors noted. “One suggested approach is that after brief training, clinicians perform the initial genetic testing, after which patients with a positive result or [variant of uncertain significance] could be referred to a geneticist or genetic counselor as needed. The results of the ENGAGE study support such a strategy.”
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.