Highlights
- •91% of mutations identified on multigene panel testing were considered actionable.
- •The majority of mutations in Ashkenazi Jewish patients were actionable.
- •The majority of mutations in Ashkenazi Jewish patients were in non-BRCA1/2 genes.
Abstract
Objective
To evaluate the results of multigene panel testing among Ashkenazi Jewish compared
with non-Ashkenazi Jewish patients.
Methods
We reviewed the medical records for all patients who underwent multigene panel testing
and targeted BRCA1/2 testing at a single institution between 6/2013–1/2015. Clinical actionability for
identified pathogenic mutations was characterized based on the National Comprehensive
Cancer Network (NCCN) guidelines and consensus statements and expert opinion for genes
not addressed by these guidelines.
Results
Four hundred and fifty-four patients underwent multigene panel screening, including
138 Ashkenazi Jewish patients. The median patient age was fifty-two years. Three hundred
and fifty-four patients (78%) had a personal history of cancer. Two hundred and fifty-one
patients had breast cancer, 49, ovarian cancer, 26, uterine cancer and 20, colorectal
cancer. We identified 62 mutations in 56 patients and 291 variants of uncertain significance
in 196 patients. Among the 56 patients with mutations, 51 (91%) had actionable mutations.
Twenty mutations were identified by multigene panels among Ashkenazi Jewish patients,
18 of which were in genes other than BRCA1/2. A review of targeted BRCA1/2 testing performed over the same study period included 103 patients and identified
six mutations in BRCA1/2, all of which occurred in Ashkenazi Jewish patients. Among all Ashkenazi Jewish
patients undergoing genetic testing, 25/183 (14%) had a mutation, 24/25 of which were
actionable (96%) and 17/25 patients (68%) had mutations in non BRCA1/2 genes.
Conclusions
With the rapid acceptance of multigene panels there is a pressing need to understand
how this testing will affect patient management. While traditionally many Ashkenazi
Jewish patients have undergone targeted BRCA1/2 testing, our data suggest consideration of multigene panels in this population as
the majority of the results are clinically actionable and often in genes other than
BRCA1/2.
Keywords
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Article info
Publication history
Published online: May 08, 2017
Accepted:
April 14,
2017
Received in revised form:
April 11,
2017
Received:
January 19,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
