Streamlining genetic testing for women with ovarian cancer in a Northern California health care system

被引:16
作者
Powell, C. Bethan [1 ,2 ]
Laurent, Cecile [1 ]
Ciaravino, Giuseppe [3 ]
Garcia, Christine [2 ]
Han, Liz [3 ]
Hoodfar, Elizabeth [4 ]
Karlea, Audrey [4 ]
Kobelka, Christine [4 ]
Lee, Jaimie [5 ]
Littell, Ramey D. [2 ]
Roh, Janise [1 ]
Vay, Agniezka [3 ]
Kushi, Lawrence H. [1 ]
机构
[1] Kaiser Permanente Northern Calif, Div Res Oakland, San Francisco, CA 94115 USA
[2] Kaiser Permanente Northern Calif, Gynecol Canc Program, 2238 Geary Blvd 2nd Floor, San Francisco, CA 94115 USA
[3] Kaiser Permanente Northern Calif, Gynecol Canc Program, Oakland, CA USA
[4] Kaiser Permanente Northern Calif, Genet Dept, San Francisco, CA 94115 USA
[5] Kaiser Permanence Oakland, Obstet & Gynecol Residency Program, Oakland, CA USA
关键词
Ovarian cancer; BRCA; Genetic testing; Streamlining; MAINTENANCE THERAPY; RISK-ASSESSMENT; BREAST; RECOMMENDATION; DISPARITIES; MUTATIONS; GERMLINE; PATTERNS; US;
D O I
10.1016/j.ygyno.2020.07.027
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective. Referral to Genetics for me-testing counseling may be inefficient for women with ovarian cancer. This study assesses feasibility of gynecologic oncologists directly offering genetic testing. Methods. A prospective pilot study was conducted at two gynecologic oncology hubs in an integrated healthcare system from May 1 to November 6, 2019. Gynecologic oncologists offered multigene panel testing to women with newly diagnosed ovarian cancer, followed by selective genetic counseling. Outcomes were compared between study participants and women from other hubs in the health system. Results. Of ovarian cancer patients at study sites, 40 participated and all underwent genetic testing. Of 101 patients diagnosed at other sites, 85% were referred to genetics (p = .0061 compared to pilot participants) and 67% completed testing (p < .0001). The time from diagnosis to blood draw and notification of result was 185 and 34 days for the pilot group compared to 25.5 and 53 days at other sites. Panel testing detected 9 (22.5%) and 7 (103%, p = .08) pathogenic mutations in each group, respectively. Patients and providers were highly satisfied with the streamlined process. Conclusion. Genetic testing performed at the gynecologic oncology point of care for patients with ovarian cancer is feasible, increases uptake of testing, and improves time to results. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:221 / 228
页数:8
相关论文
共 30 条
[1]   BRCA Mutation Frequency and Patterns of Treatment Response in BRCA Mutation-Positive Women With Ovarian Cancer: A Report From the Australian Ovarian Cancer Study Group [J].
Alsop, Kathryn ;
Fereday, Sian ;
Meldrum, Cliff ;
deFazio, Anna ;
Emmanuel, Catherine ;
George, Joshy ;
Dobrovic, Alexander ;
Birrer, Michael J. ;
Webb, Penelope M. ;
Stewart, Colin ;
Friedlander, Michael ;
Fox, Stephen ;
Bowtell, David ;
Mitchell, Gillian .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (21) :2654-2663
[2]   A brief assessment of concerns associated with genetic testing for cancer: The Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire [J].
Cella, D ;
Hughes, C ;
Peterman, A ;
Chang, CH ;
Peshkin, BN ;
Schwartz, MD ;
Wenzel, L ;
Lemke, A ;
Marcus, AC ;
Lerman, C .
HEALTH PSYCHOLOGY, 2002, 21 (06) :564-572
[3]   National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer [J].
Childers, Christopher P. ;
Childers, Kimberly K. ;
Maggard-Gibbons, Melinda ;
Macinko, James .
JOURNAL OF CLINICAL ONCOLOGY, 2017, 35 (34) :3800-+
[4]   Veliparib with First-Line Chemotherapy and as Maintenance Therapy in Ovarian Cancer [J].
Coleman, R. L. ;
Fleming, G. F. ;
Brady, M. F. ;
Swisher, E. M. ;
Steffensen, K. D. ;
Friedlander, M. ;
Okamoto, A. ;
Moore, K. N. ;
Ben-Baruch, N. Efrat ;
Werner, T. L. ;
Cloven, N. G. ;
Oaknin, A. ;
DiSilvestro, P. A. ;
Morgan, M. A. ;
Nam, J. -H. ;
Leath, C. A., III ;
Nicum, S. ;
Hagemann, A. R. ;
Littell, R. D. ;
Cella, D. ;
Baron-Hay, S. ;
Garcia-Donas, J. ;
Mizuno, M. ;
Bell-McGuinn, K. ;
Sullivan, D. M. ;
Bach, B. A. ;
Bhattacharya, S. ;
Ratajczak, C. K. ;
Ansell, P. J. ;
Dinh, M. H. ;
Aghajanian, C. ;
Bookman, M. A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2019, 381 (25) :2403-2415
[5]   Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer [J].
Colombo, Nicoletta ;
Huang, Gloria ;
Scambia, Giovanni ;
Chalas, Eva ;
Pignata, Sandro ;
Fiorica, James ;
Van Le, Linda ;
Ghamande, Sharad ;
Gonzalez-Santiago, Santiago ;
Bover, Isabel ;
Grana Suarez, Begona ;
Green, Andrew ;
Huot-Marchand, Philippe ;
Bourhis, Yann ;
Karve, Sudeep ;
Blakeley, Christopher .
JOURNAL OF CLINICAL ONCOLOGY, 2018, 36 (13) :1300-+
[6]   Multiplex Genetic Testing for Cancer Susceptibility: Out on the High Wire Without a Net? [J].
Domchek, Susan M. ;
Bradbury, Angela ;
Garber, Judy E. ;
Offit, Kenneth ;
Robson, Mark E. .
JOURNAL OF CLINICAL ONCOLOGY, 2013, 31 (10) :1267-1270
[7]   Adherence patterns to National Comprehensive Cancer Network (NCCN) guidelines for referral to cancer genetic professionals [J].
Febbraro, Terri ;
Robison, Katina ;
Wilbur, Jennifer Scalia ;
Laprise, Jessica ;
Bregar, Amy ;
Lopes, Vrishali ;
Legare, Robert ;
Stuckey, Ashley .
GYNECOLOGIC ONCOLOGY, 2015, 138 (01) :109-114
[8]   Comparison of risk management strategies between women testing positive for a BRCA variant of unknown significance and women with known BRCA deleterious mutations [J].
Garcia, Christine ;
Lyon, Liisa ;
Littell, Ramey D. ;
Powell, C. Bethan .
GENETICS IN MEDICINE, 2014, 16 (12) :896-902
[9]   Implementing rapid, robust, cost-effective, patient-centred, routine genetic testing in ovarian cancer patients [J].
George, Angela ;
Riddell, Daniel ;
Seal, Sheila ;
Talukdar, Sabrina ;
Mahamdallie, Shazia ;
Ruark, Elise ;
Cloke, Victoria ;
Slade, Ingrid ;
Kemp, Zoe ;
Gore, Martin ;
Strydom, Ann ;
Banerjee, Susana ;
Hanson, Helen ;
Rahman, Nazneen .
SCIENTIFIC REPORTS, 2016, 6
[10]   Niraparib in Patients with Newly Diagnosed Advanced Ovarian Cancer [J].
Gonzalez-Martin, A. ;
Pothuri, B. ;
Vergote, I. ;
DePont Christensen, R. ;
Graybill, W. ;
Mirza, M. R. ;
McCormick, C. ;
Lorusso, D. ;
Hoskins, P. ;
Freyer, G. ;
Baumann, K. ;
Jardon, K. ;
Redondo, A. ;
Moore, R. G. ;
Vulsteke, C. ;
O'Cearbhaill, R. E. ;
Lund, B. ;
Backes, F. ;
Barretina-Ginesta, P. ;
Haggerty, A. F. ;
Rubio-Perez, M. J. ;
Shahin, M. S. ;
Mangili, G. ;
Bradley, W. H. ;
Bruchim, I. ;
Sun, K. ;
Malinowska, I. A. ;
Li, Y. ;
Gupta, D. ;
Monk, B. J. .
NEW ENGLAND JOURNAL OF MEDICINE, 2019, 381 (25) :2391-2402