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
508P - Efficacy and safety of anti-PD-1 antibody SHR-1210 combined with apatinib in first-line treatment for advanced lung squamous carcinoma: A phase II study
Presenter: Jinliang Wang
Session: Poster display session
Resources:
Abstract
525P - Retrospective analysis of outcomes of cisplatin and irinotecan combination chemotherapy for unresectable thymic carcinoma
Presenter: Akito Fukuda
Session: Poster display session
Resources:
Abstract
524P - A study in recurrent small cell lung cancer patients, comparing weekly paclitaxel, irinotecan and temozolomide in second-line: A prospective study from a south Indian tertiary cancer hospital
Presenter: LALATENDU MOHARANA
Session: Poster display session
Resources:
Abstract
505P - PD-L1 expression in ALK rearranged NSCLC: All questions answered?
Presenter: Amrith B P
Session: Poster display session
Resources:
Abstract
487P - Afatinib versus gefitinib or erlotinib in first-line setting for Malaysia patients with EGFR mutant advanced lung adenocarcinoma
Presenter: Chee Shee Chai
Session: Poster display session
Resources:
Abstract
492P - Feasibility of rebiopsy and sequential treatment of EGFR tyrosine kinase inhibitors in real world patients with EGFR mutant non-small cell lung cancer
Presenter: Heekyung Ahn
Session: Poster display session
Resources:
Abstract
513P - Phase II study of vitamin B12 and folate supplementation for patients undergoing chemotherapy with pemetrexed
Presenter: Shingo Kitagawa
Session: Poster display session
Resources:
Abstract
493P - Is exon 19 deletion different from exon 21 mutation in advanced non-small cell lung cancer: A single centre experience
Presenter: Sarita Shrivastva
Session: Poster display session
Resources:
Abstract
494P - Comparison of pattern of disease progression and prevalence of acquired T790M mutation in Malaysia patients with EGFR mutant lung adenocarcinoma upon failure of first-line afatinib, gefitinib and erlotinib
Presenter: Chee Shee Chai
Session: Poster display session
Resources:
Abstract
517P - High BRCA1 expression is independently correlated with decreased overall survival in lung adenocarcinoma: Evidence from meta and bioinformatics analyses
Presenter: Fengzhu Guo
Session: Poster display session
Resources:
Abstract