Pretest Video Education Versus Genetic Counseling for Patients With Prostate Cancer: ProGen, A Multisite Randomized Controlled Trial

被引:4
作者
Rana, Huma Q. [1 ,2 ,8 ]
Stopfer, Jill E. [1 ,2 ]
Weitz, Michelle [1 ]
Kipnis, Lindsay [2 ]
Koeller, Diane R. [2 ]
Culver, Samantha [2 ]
Mercado, Joanna [2 ]
Gelman, Rebecca Sue [1 ]
Underhill-Blazey, Meghan [1 ,2 ]
Mcgregor, Bradley A. [1 ,3 ]
Sweeney, Christopher J. [1 ,3 ]
Petrucelli, Nancie [4 ]
Kokenakes, Courtney [4 ]
Pirzadeh-Miller, Sara [5 ]
Reys, Brian [5 ]
Frazier, Arthur [6 ]
Knechtl, Andrew [6 ]
Fateh, Salman [6 ]
Vatnick, Donna Rachel [2 ]
Silver, Rebecca [3 ]
Kilbridge, Kerry E. [1 ,3 ]
Pomerantz, Mark M. [1 ,3 ]
Wei, Xiao X. [1 ,3 ]
Choudhury, Atish D. [1 ,3 ]
Sonpavde, Guru P. [1 ,3 ]
Kozyreva, Olga [1 ]
Lathan, Christopher [1 ]
Horton, Carrie [7 ]
Dolinsky, Jill S. [7 ]
Heath, Elisabeth I. [4 ]
Ross, Theodora Suzanne [5 ]
Courtney, Kevin Dale [5 ]
Garber, Judy E. [1 ,2 ]
Taplin, Mary-Ellen [1 ,3 ]
机构
[1] Dana Farber Canc Inst, Med Oncol, Boston, MA USA
[2] Dana Farber Canc Inst, Canc Genet & Prevent, Boston, MA USA
[3] Dana Farber Canc Inst, Lank Ctr Genitourinary Oncol, Boston, MA USA
[4] Wayne State Univ, Karmanos Canc Inst, Detroit, MI USA
[5] Univ Texas Southwestern Med Ctr, Dallas, TX USA
[6] McLaren Clarkston, Karmanos Canc Inst, Clarkston, MI USA
[7] Ambry Genet, Aliso Viejo, CA USA
[8] Dana Farber Canc Inst, 450 Brookline Ave, Boston, MA 02215 USA
关键词
OVARIAN-CANCER; HEREDITARY BREAST; WOMEN; TELEPHONE; MUTATIONS; IMPACT;
D O I
10.1200/OP.23.00007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In this large, multisite RCT, pretest video education shows promise for men with prostate cancer. PURPOSEGermline genetic testing (GT) is recommended for men with prostate cancer (PC), but testing through traditional models is limited. The ProGen study examined a novel model aimed at providing access to GT while promoting education and informed consent.METHODSMen with potentially lethal PC (metastatic, localized with a Gleason score of >= 8, persistent prostate-specific antigen after local therapy), diagnosis age <= 55 years, previous malignancy, and family history suggestive of a pathogenic variant (PV) and/or at oncologist's discretion were randomly assigned 3:1 to video education (VE) or in-person genetic counseling (GC). Participants had 67 genes analyzed (Ambry), with results disclosed via telephone by a genetic counselor. Outcomes included GT consent, GT completion, PV prevalence, and survey measures of satisfaction, psychological impact, genetics knowledge, and family communication. Two-sided Fisher's exact tests were used for between-arm comparisons.RESULTSOver a 2-year period, 662 participants at three sites were randomly assigned and pretest VE (n = 498) or GC (n = 164) was completed by 604 participants (VE, 93.1%; GC, 88.8%), of whom 596 participants (VE, 98.9%; GC, 97.9%) consented to GT and 591 participants completed GT (VE, 99.3%; GC, 98.6%). These differences were not statistically significant although subtle differences in satisfaction and psychological impact were. Notably, 84 PVs were identified in 78 participants (13.2%), with BRCA1/2 PV comprising 32% of participants with a positive result (BRCA2 n = 21, BRCA1 n = 4).CONCLUSIONBoth VE and traditional GC yielded high GT uptake without significant differences in outcome measures of completion, GT uptake, genetics knowledge, and family communication. The increased demand for GT with limited genetics resources supports consideration of pretest VE for patients with PC.
引用
收藏
页码:1069 / +
页数:16
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