Novel Counseling Model for Genetic Testing in Patients With Ovarian Cancer
Posted: Tuesday, June 19, 2018
An international study published in the Journal of Clinical Oncology has shown that an oncologist-led BRCA1/2 mutation (BRCAm) testing process may be feasible in patients with ovarian cancer. Given the growing demand for such testing in this patient population, “pretesting counseling by the oncology team could shorten testing turnaround times and ease the pressure on genetic counselors,” stated study author Nicoletta Colombo, MD, of the European Institute of Oncology, University of Milan, Italy, and colleagues.
The prospective, observational ENGAGE study included 700 women diagnosed with epithelial ovarian, fallopian tube, or peritoneal cancer from 26 sites in the United States, Italy, and Spain. A clinical team consisting of both oncologists and oncology nurses were trained on how to discuss BRCAm testing with patients and on techniques of genetic counseling; then such patient counseling was provided to patients before and after BRCAm testing.
Among the study objectives were assessment of turnaround time, patients’ impression of such genetic counseling, and geneticist/genetic counselor’s satisfaction with the testing pathway. A total of 18 geneticists or genetic counselors completed satisfaction surveys, and 634 patients completed the study.
Dr. Colombo and colleagues reported a median overall turnaround time of 9.1 weeks, with the shortest time in the United States (4.1 weeks vs. 20.4 weeks in Italy and 12.0 weeks in Spain). Nearly all patients seemed to be satisfied with the counseling both before and after BRCAm testing. More than 80% of oncologists reported being satisfied with the testing pathway. However, geneticists or genetic counselors appeared to be less enthusiastic about the testing pathway than oncologists.