Abstract 234P
Background
The literature reports that a minority of women with epithelial ovarian cancer (EOC) are referred for germline BRCA testing despite implications for treatment and cancer prevention. Mainstream testing is BRCA testing undertaken by the Medical Oncology service, rather than clinical genetics; and it was introduced at Auckland Hospital in 2017. This study assessed whether the implementation of mainstreaming increased the uptake and timeliness of BRCA testing in a multi-cultural tertiary centre.
Methods
A retrospective analysis of women with high grade non-mucinous EOC attending Medical Oncology clinic was performed prior to and after the introduction of mainstream testing. Eligibility for BRCA testing included those with the above diagnosis ≤ 70 years (tested by Medical Oncology after mainstreaming introduced) and patients > 70 years with a personal and/or relevant family history (tested by genetics). The primary outcome was the proportion of eligible patients who underwent BRCA testing. A secondary outcome was the time to the availability of the BRCA test result.
Results
The proportion of eligible women tested for germline BRCA mutations significantly increased (Table). The improvement was due to increased testing via mainstreaming; there was no change in the proportion of women tested through the Genetics service. Efficiency of testing also improved; the median time from Genetics referral to an available BRCA result was 146 days (range 37 to 1599 days) and from Medical Oncology assessment to BRCA test result 64 days (range 34 to 471 days) before and after mainstreaming respectively. Overall, 14.9% of women had germline BRCA 1 or 2 mutations.
Table: 234P
Pre- mainstreaming | Post- mainstreaming | P value | |
---|---|---|---|
Eligible for mainstreaming* | 108/177 (61.0%) | 37/40 (92.5%) | 0.0001 |
>70 years + personal/ family history** | 10/15 (66.7%) | 7/9 (77.8%) | 0.6687 |
Overall | 118/192 (61.5%) | 44/49 (89.8%) | 0.0001 |
Pre-mainstreaming, patients tested by Genetics; post-mainstreaming, tested in Medical Oncology clinic.
**Tested by Genetics.
Conclusions
Mainstream testing for germline BRCA mutations improved quality – access and timeliness – for women with EOC. Efficiency of testing will have important therapeutic implications.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Auckland District Health Board.
Funding
Auckland District Health Board.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
164P - Multi-centered phase II trial of weekly 5-FU plus l-LV regimen as salvage line chemotherapy for oral fluorouracil resistant advanced gastric cancer (HGCSG1502)
Presenter: Yusuke Sasaki
Session: Poster display session
Resources:
Abstract
165P - Lenvatinib treatment for advanced hepatocellular carcinoma: The relationship between efficacy and safety
Presenter: Takayoshi Oikawa
Session: Poster display session
Resources:
Abstract
166P - The comparison between UGT1A1 single heterozygous and wild type regarding the clinical outcomes of fixed dose irinotecan monotherapy for advanced gastric cancer: Multicenter retrospective study
Presenter: Takahide Sasaki
Session: Poster display session
Resources:
Abstract
167P - Prognostic impact of the C-reactive protein/albumin ratio in advanced pancreatic cancer treated with GEM plus nab-PTX or FOLFIRINOX: Based on the results of a multicenter retrospective study (the NAPOLEON study)
Presenter: Akitaka Makiyama
Session: Poster display session
Resources:
Abstract
168P - A retrospective multicenter study evaluating the efficacy and safety of irinotecan in patients with advanced gastric cancer: Analysis of Glasgow Prognostic Score (GPS)
Presenter: Takuya Honda
Session: Poster display session
Resources:
Abstract
169P - M-phase phosphoprotein 8 promotes gastric cancer growth and metastasis via p53/Bcl-2 and EMT-related signalling pathways
Presenter: Yizhuo Wang
Session: Poster display session
Resources:
Abstract
170P - Surgery alone versus surgery combined with Chemotherapy: Survival patterns among patients with fibrolamellar hepatocellular carcinoma
Presenter: Yasmine Ashraf
Session: Poster display session
Resources:
Abstract
171P - The clinical value of prognostic nutritional index in patients with anastomotic leakage after minimally invasive esophagectomy
Presenter: Yan Wang
Session: Poster display session
Resources:
Abstract
172P - Preoperative neutrophil‐to‐lymphocyte ratio (NLR) predicts recurrence after surgery in patient with pancreatic neuroendocrine neoplasm (PanNEN)
Presenter: Takayuki Miura
Session: Poster display session
Resources:
Abstract
173P - Cancer stem-like phenotypes including immune surveillance and its responsible genes in induced liver cancer stem-like cells
Presenter: Ryouichi Tsunedomi
Session: Poster display session
Resources:
Abstract