FDA Approval of PARP Inhibitors and the Impact on Genetic Counseling and Genetic Testing Practices

被引:20
作者
Buchtel, Kathryn M. [1 ,2 ]
Postula, Kristen J. Vogel [3 ]
Weiss, Shelly [4 ]
Williams, Carmen [5 ]
Pineda, Mario [5 ]
Weissman, Scott M. [3 ]
机构
[1] Northwestern Univ, Grad Program Genet Counseling, Chicago, IL 60611 USA
[2] 2840 Elaine Dr, Broomfield, CO 80020 USA
[3] GeneDx, Gaithersburg, MD USA
[4] Myriad Genet Labs, Salt Lake City, UT USA
[5] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA
关键词
PARP inhibitor; Olaparib; Companion diagnostics; Genetic counseling; Genetic testing; Ovarian cancer; BRCA1; BRCA2; OVARIAN-CANCER; POLY(ADP-RIBOSE) POLYMERASE; BREAST-CANCER; BRCA2; MUTATIONS; CARCINOMA; TUMORS; RISKS;
D O I
10.1007/s10897-017-0130-7
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
In December 2014, the FDA approved olaparib, a poly(ADP-ribose) polymerase inhibitor (PARPi) for ovarian cancer patients who have failed three or more lines of chemotherapy and have a germline BRCA1/2 mutation identified through a companion diagnostic test (BRACAnalysis CDx (TM) (CDx (TM))) offered exclusively by Myriad Genetic Laboratories. This study explored the impact of PARPi/CDx (TM) on genetic counselors' (GCs) counseling and testing practices. One hundred twenty three GCs responded to an online survey regarding pre- and post-FDA approval referral patterns, testing strategies/influences, and anecdotal experiences with insurance coverage of PARPi for BRCA1/2 positive patients through a non-CDx (TM) platform. Following PARPi approval, 40% of respondents reported an increase in overall referrals of ovarian cancer patients and 20% had an increase in post-test counseling only referrals. The majority (61.9%) of respondents reported no change in genetic testing strategy, and there was no change in factors influencing choice of testing laboratory. Nearly all (98.1%) respondents who had experience with insurance covering PARPi indicated approval with mutations identified via non-CDx (TM) testing. Respondents indicated an increase in referral volume following FDA approval of PARPi/CDx (TM), but did not report changes in testing practices. Respondents were not aware of PARPi insurance coverage denial in the absence of CDx (TM).
引用
收藏
页码:131 / 139
页数:9
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