Highlights
- •<25% of ovarian cancer patients in the U.S. receive recommended genetics services.
- •We increased the rates of genetic counseling and testing to over 85% in our clinic.
- •Various interventions were used to increase rates of genetic counseling and testing.
- •Physician-coordinated genetic testing of ovarian cancer patients is an option.
- •Genetic testing results can impact ovarian cancer treatment options.
Abstract
Objective
Genetic counseling (GC) and germline genetic testing (GT) for BRCA1 and BRCA2 are considered standard of care for patients with high-grade, non-mucinous epithelial
ovarian, fallopian tube, and primary peritoneal cancers (HGOC). We describe a universal
genetic testing initiative to increase the rates of recommendation and acceptance
of GC and GT to >80% for patients with HGOC at our institution.
Methods
Data from a consecutive cohort of patients seen in our gynecologic oncology clinics
between 9/1/2012 and 8/31/2015 for evaluation of HGOC were retrospectively analyzed.
Data were abstracted from the tumor registry, medical records, and research databases.
Descriptive statistics were used to evaluate patient characteristics and GC, GT, and
PARP inhibitor use. Various clinic interventions were developed, influenced by the
Plan-Do-Study-Act cycle method, which included physician-coordinated GT, integrated
GC, and assisted GC referrals.
Results
A cohort of 1636 patients presented to the gynecologic oncology clinics for evaluation
of HGOC during our study period, and 1423 (87.0%) were recommended to have GC and
GT. Of these, 1214 (85.3%) completed GT and 217 (17.9%) were found to have a BRCA1 or BRCA2 mutation. Among BRCA-positive patients, 167 had recurrent or progressive disease,
and 56 of those received PARP inhibitor therapy.
Conclusions
The rates of GC and GT recommendation and completion among patients with HGOC at our
institution exceeded 80% following the implementation of a universal genetic testing
initiative. Universal genetic testing of patients with HGOC is one strategy to identify
those who may benefit from PARP inhibitor therapy.
Keywords
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Article info
Publication history
Published online: June 13, 2017
Accepted:
May 27,
2017
Received in revised form:
May 26,
2017
Received:
May 4,
2017
Footnotes
☆This project was funded by The University of Texas MD Anderson Cancer Center Breast and Ovarian Cancer Moon Shot™ Program and Phillips 66. This work was also supported by the NIH/NCI under award number P30CA016672 (used the Clinical Trials Support Resource and the Biostatistics Resource Group). Dr. Shannon Westin is supported by the Andrew Sabin Family Fellowship.
Identification
Copyright
© 2017 Published by Elsevier Inc.
