Abstract 580P
Background
Biomarker tests inform physicians on optimal treatment strategies to improve outcomes for patients (pts) with advanced ovarian cancer (AOC). We explored use of breast cancer susceptibility genes (BRCA) and homologous recombinant deficiency (HRD) testing in informing management of AOC.
Methods
Participants from Canada, Japan, France, Germany, Italy, Spain, and the United Kingdom completed a point-in-time survey, May-Aug 2021, reporting their use of BRCA and HRD testing in managing AOC pts. Eligible participants were gynaecology/oncology specialists, involved in AOC management, seeing ≥10 AOC pts/month. Where no country-specific differences were seen, we report results across the whole sample.
Results
Of 300 participants, 68% were male and 79% specialised in 1997 or later. Participants saw a mean 24 (standard deviation [SD]: ±17) stage III/IV AOC pts/month. Participants estimated BRCA testing in a mean 72% (SD:±30) of newly diagnosed AOC pts in the past 6 months. Testing increased in the last 2 years by 23% to 73% in Europe and by 29% to 90% in Canada. Table shows reasons for/against BRCA and HRD testing. 67% were aware of HRD testing; of these 83% (n=128/155) expressed confidence in discussing HRD with pts and 79% (n=123/155) with peers. Participants in Canada estimated 6% (SD:±17) of their pts received HRD testing, compared with 27% (SD:±28) in Europe and 33% (SD:±25) in Japan. 81% of participants agreed that genetic counselling should be offered to OC pts.
Conclusions
While most AOC pts are reportedly tested for BRCA, HRD testing is not yet routinely requested in clinical practice. Only half of participants reported biomarker testing due to treatment implications. While poor pt performance status and inadequate tissue remain challenges in biomarker testing, by improving access and education to testing, more AOC pts could receive biomarker- directed and timely therapy. Table: 580P
| Physicians who conduct biomarker tests in at least some patients | |||
| BRCA germline test | BRCA tumour test | HRD test† | |
| Most important reason for testing (top 4) | n=289 | n=273 | n=146 |
| Treatment implications of the test | 47% | 53% | 51% |
| Recommended in clinical guidelines | 38% | 27% | 15% |
| Biomarker predicts treatment response | 9% | 10% | 20% |
| Testing mandated by insurer | 3% | 5% | 4% |
| Physicians who conduct biomarker test in all patients | |||
| BRCA germline test | BRCA tumour test | HRD test† | |
| Most important reasons against testing (top 4) | n=206 | n=220 | n=168 |
| Poor performance | 22% | 21% | 12% |
| Patients do not want to undergo this test | 21% | 11% | 7% |
| Inadequate tissue | 15% | 28% | 19% |
| Reimbursement issues | 9% | 10% | 18% |
† n=3 and n=12 in Canada gave reasons for and against HRD testing, respectively.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
AstraZeneca.
Funding
This study was supported by AstraZeneca and Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA who are codeveloping olaparib.
Disclosure
G. Valabrega: Financial Interests, Personal, Other, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: PharmaMar, AstraZeneca, MSD, Clovis Oncology, GSK, EISAI; Financial Interests, Personal, Other, Support for attending meetings and/or travel: PharmaMar; Financial Interests, Personal, Other, Participation on a Data Safety Monitoring Board or Advisory Board: EISAI, AstraZeneca, MSD, Clovis Oncology, GSK; Financial Interests, Personal, Other, Consulting fees: AstraZeneca, MSD, GSK. R.N. Eskander: Financial Interests, Personal, Other, All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): AstraZeneca; Financial Interests, Personal, Other, Consulting fees: AstraZeneca, Clovis Oncology, Eisai, Myriad, Novocure, Elevar Therapeutics, Immunogen, GSK, Tesaro, Seagen; Financial Interests, Personal, Other, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: AstraZeneca, Clovis Oncology, Seagen; Financial Interests, Personal, Other, Leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: ClearityFoundation, GOGFoundation. T. Bailey: Financial Interests, Personal, Other, All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): Adelphi Real World. W. Ambler: Financial Interests, Personal, Other, All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): Adelphi Real World. S. Volpe: Financial Interests, Personal, Full or part-time Employment: AstraZeneca; Financial Interests, Personal, Other, Stock or other ownership: GSK. O. Ozgoren: Financial Interests, Personal, Other, All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): AstraZeneca Pharmaceuticals LP, Cambridge, UK; Financial Interests, Personal, Other, Royalties or licenses: AstraZeneca Pharmaceuticals LP, Cambridge, UK; Financial Interests, Personal, Other, Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events: AstraZeneca Pharmaceuticals LP, Cambridge, UK; Financial Interests, Personal, Other, Support for attending meetings and/or travel: AstraZeneca Pharmaceuticals LP, Cambridge, UK; Financial Interests, Personal, Other, Stock or stock options: AstraZeneca Pharmaceuticals LP, Cambridge, UK; Financial Interests, Personal, Other, financial or non-financial interests: AstraZeneca Pharmaceuticals LP, Cambridge, UK. N. Alam: Financial Interests, Personal, Full or part-time Employment: AstraZeneca, Amgen; Financial Interests, Personal, Other, Stock or other ownership: AstraZeneca, Amgen; Financial Interests, Personal, Other, Research funding: AstraZeneca, Amgen. G. Long: Financial Interests, Personal, Other, All support for the present manuscript (e.g., funding, provision of study materials, medical writing, article processing charges, etc.): AstraZeneca ; Financial Interests, Personal, Other, Support for attending meetings and/or travel: AstraZeneca ; Financial Interests, Personal, Other, Stock or stock options: AstraZeneca . S. Banerjee: Financial Interests, Personal, Advisory Board: Amgen, Genmab, Immunogen, Mersana, Merck Sereno, MSD, Roche, Tesaro, AstraZeneca, GSK, Oncxerna; Financial Interests, Personal, Invited Speaker: Clovis, Pfizer, Tesaro, AstraZeneca, GSK, Takeda, Amgen, Medscape, Research to Practice, Peerview; Financial Interests, Personal, Stocks/Shares: PerciHealth; Financial Interests, Institutional, Research Grant: AstraZeneca, GSK, Tesaro; Non-Financial Interests, Principal Investigator, Phase II clinical trial Global lead, ENGOTov60/GOG3052/RAMP201: Verastem; Non-Financial Interests, Principal Investigator, ENGOT-GYN1/ATARI phase II international trial (academic sponsored): Astrazeneca; Non-Financial Interests, Advisory Role: Epsilogen; Non-Financial Interests, Other, Member of membership committee: ESGO; Non-Financial Interests, Advisory Role, Medical advisor to UK ovarian cancer charity: Ovacome Charity; Non-Financial Interests, Other, Received research funding from UK based charity I have provided medical advice (non-remunerated): Lady GardenFoundation Charity.