Abstract 378P
Background
Tan Tock Seng Hospital (TTSH) Cancer Genetics and Genomics Clinic (CGGC) was set up by the Personalised Medicine Services (PMS) and Department of Medical Oncology (DMO) in December 2017 to provide genetic counselling service for inherited cancer syndromes diagnosis, risk assessment and treatment recommendation. Patient’s affordability for genetic testing was noted as one of the greatest challenges. In January 2019, a diagnostic access program was established between AstraZeneca Singapore and PMS to reduce cost barriers for patients who fulfil clinical guidelines for BRCA1/2 testing.
Methods
This is a retrospective study of BRCA1/2 test utilisation by patients who were seen at CGGC. The oncologist made the decision on the use of a targeted BRCA1/2 or multi-gene panels for genetic testing. The objectives of this study were to examine the clinical utilisation of BRCA1/2 testing, and to determine the proportion of patients who benefited from the access program.
Results
To date, 101 out of 140 patients were seen at CGGC for BRCA-related testing. Patients’ referral are mainly from DMO and Breast Clinic. With the increased use of PARP inhibitors for germline BRCA-mutated cancers, the number of patients referred to CGGC has increased 20% per month. The percentage of breast, prostate, pancreatic and ovarian cancer patients seen are 75%, 11%, 10% and 5%, respectively. The introduction of the access program has greatly increased the testing rate from 50% to 85%. The positive detection rate was 11%. Among 65 that underwent testing, 7 patients were tested BRCA1/2 mutation positive, which resulted in protein truncation or disruption. However, the take up rate for carrier testing was low, probably due to fear of being affected and insurance discrimination. The variant of unknown significance rate for BRCA1/2 was 14%. Among the 75% tested BRCA1/2 negative, a genetic cause of their cancer cannot be ruled out. For example, 2 BRCA1/2 negative breast cancer patients were tested positive in CHEK2 and PALB2 genes.
Conclusions
CGGC service in TTSH is growing rapidly and has closed an important gap in our patient treatment journey. The sponsorship by AstraZeneca has greatly benefited our patients who might be at risk of inherited cancer syndromes and would potentially benefit from PARP inhibitors treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Tan Tock Seng Hospital.
Funding
AstraZeneca Singapore.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
117P - Short-term and long-term outcomes of hepatectomy combined with intraoperative radiofrequency ablation for multiple colorectal liver metastases: A propensity score matching study
Presenter: Wenbai Huang
Session: Poster display session
Resources:
Abstract
119P - The impacts of dose-time-fractionation schedules on pathological complete response rate (pCR) and local recurrence (LR)
Presenter: Fu Jin
Session: Poster display session
Resources:
Abstract
120P - Platelet to lymphocyte ratio is associated with tumour localization and outcomes in patients with metastatic colorectal cancer
Presenter: Ahmet Bilici
Session: Poster display session
Resources:
Abstract
121P - Meta-analysis of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer
Presenter: Laiyuan Li
Session: Poster display session
Resources:
Abstract
127P - Outcomes based on albumin‐bilirubin (ALBI) grade in the phase III CELESTIAL trial of cabozantinib versus placebo in patients with advanced hepatocellular carcinoma (HCC)
Presenter: Stephen Chan
Session: Poster display session
Resources:
Abstract
128P - Tislelizumab in combination with chemotherapy for Chinese patients (Pts) with gastric/gastroesophageal junction cancer (GC/GEJC) or esophageal squamous cell carcinoma (ESCC)
Presenter: Yuxian Bai
Session: Poster display session
Resources:
Abstract
129P - Monitoring patient-specific mutation in ctDNA and CTC for tumour response evaluation after neoadjuvant chemotherapy in advanced gastric adenocarcinoma (NCT03425058)
Presenter: Tao Fu
Session: Poster display session
Resources:
Abstract
130P - Development of a liver cancer risk prediction model for the general population in china: A potential tool for screening
Presenter: Xiaoshuang Feng
Session: Poster display session
Resources:
Abstract
131P - Cabozantinib in Asian patients with hepatocellular carcinoma and other solid tumours: Population pharmacokinetics analysis
Presenter: Chih-Hung Hsu
Session: Poster display session
Resources:
Abstract
132P - Liposomal irinotecan (nal-IRI) plus 5-fluorouracil/levoleucovorin (5 FU/LV) vs 5-FU/LV in Japanese patients (pts) with gemcitabine-refractory metastatic pancreatic cancer (mPAC)
Presenter: Tatsuya Ioka
Session: Poster display session
Resources:
Abstract