Abstract 1773P
Background
Cancer genetics clinics are struggling to cope with increasing referrals of breast and ovarian cancer (BC/OC) patients. The approval of anti-PARP for cases with germline BRCA1/2 pathogenic variants (PV) and the associated necessity for the oncologist to receive results rapidly are compounding these difficulties. Mainstreamed genetic testing (MGT) via oncologists and gynecologists obviates the need for a genetics consultation for most patients, as only complex cases and PV carriers are referred. We report results from an MGT project involving a Paris University hospital and two regional hospitals, and show how MGT guaranteed care continuity during the COVID-19 pandemic.
Methods
Oncologists and gynecologists participated voluntarily. They were sent an e-learning module summarizing the principles of genetic susceptibility to BC/OC, patient selection, consent, carrier management, and highlighting the importance of cascade testing in relatives. A computerized and adapted version of the Manchester Scoring System was used for patient selection. Only index cases with cancer and aged > 30 were included. The oncologist or gynecologist provided basic genetic counseling and gave patients an information sheet. A single academic laboratory performed all analyses.
Results
During the 01.2018 – 05.2020 period, MGT was carried out in 244 patients with an average age of 51. PV detection rate in the BRCA1/2, PALB2, and RAD51C/D major genes was 11%. All carriers were subsequently seen by a cancer geneticist. Whenever possible, patients with negative results were discussed at a multidisciplinary meeting involving a geneticist or a genetic counselor. 27 of the reported patients had MGT during the 8-week COVID-19 lockdown.
Conclusions
We report the successful implementation of MGT in France for BC/OC patients. It allowed for immediate testing at their point of care of eligible patients. Results were rapidly returned, and all PV carriers were seen by a cancer geneticist. The PV detection rate was similar to rates observed using traditional testing pathways. Of note, MGT guaranteed continuity of care during the COVID-19 lockdown, when all medical activity considered nonessential, including cancer genetics, was drastically reduced.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.