Mainstreaming genetic counselling for genetic testing of BRCA1/2 in ovarian cancer patients in Malaysia (MaGIC study)

Yoon, Sook‐Yee; Wong, Siu Wan; Ahmad, Naseem; Mariapun, Shivaani; Hassan, Tiara; Padmanabhan, H.; Lim, Joanna; George, Angela; Thong, Meow‐Keong; Ch’ng, Gaik-Siew; Teo, Soo‐Hwang; Bleiker, Eveline M. A.; Woo, Yin Ling

doi:10.1093/annonc/mdz446.010

Cited by 4 publications

(4 citation statements)

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“…The model assumes different resource use rates for all stages, reflecting clinical practice. Similarly, the cost of testing for BRCA was accounted for as a one-off cost for all patients receiving olaparib, assuming a 13.9% BRCA positive rate [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia

Yong,

Yehgambaram,

Lee

2024

PLoS ONE

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Introduction Ovarian cancer is one of the most common cancer among women in Malaysia. Patients with ovarian cancer are often diagnosed at an advanced stage. Despite initial response to surgery and chemotherapy, most patients will experience a relapse. Olaparib has been reported have promising effects among BRCA mutated ovarian cancer patients. This study aimed to evaluate the cost–effectiveness of olaparib as a maintenance therapy for BRCA ovarian cancer in Malaysia. Methods We developed a four-state partitioned survival model which compared treatment with olaparib versus routine surveillance (RS) from a Malaysian healthcare perspective. Mature overall survival (OS) data from the SOLO-1 study were used and extrapolated using parametric models. Medication costs and healthcare resource usage costs were derived from local inputs and publications. Deterministic and probabilistic sensitivity analyses (PSA) were performed to explore uncertainties. Results In Malaysia, treating patients with olaparib was found to be more costly compared to RS, with an incremental cost of RM149,858 (USD 33,213). Patients treated with olaparib increased life years by 3.05 years and increased quality adjusted life years (QALY) by 2.76 (9.45 years vs 6.40 years; 7.62 vs 4.86 QALY). This translated to an incremental cost-effectiveness ratio (ICER) of RM 49,159 (USD10,895) per life year gained and RM54,357 (USD 12,047) per QALY gained, respectively. ICERs were most sensitive to time horizon of treatment, discount rate for outcomes, cost of treatment and health state costs, but was above the RM53,770/QALY threshold. Conclusion The use of olaparib is currently not a cost-effective strategy compared to routine surveillance based upon the current price in Malaysia for people with ovarian cancer with BRCA mutation, despite the improvement in overall survival.

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Section: Methodsmentioning

confidence: 99%

Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia

Yong,

Yehgambaram,

Lee

2024

PLoS ONE

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“…Setting up standardized workflows and training eligible counselors is pivotal for promoting genetic counseling in China. Although the "oncologist-led BRCA consultation" mode has improved access to cancer genetic testing in developing countries (93), specialized cancer genetic counselors are urgently needed. Organizations like the Chinese Board of Genetic Counseling and others are now dedicated to training genetic counselors in more than 15 provinces across China (65).…”

Section: Genetic Counseling For Brca Mutation Carriers In Chinamentioning

confidence: 99%

Overview on population screening for carriers with germline BRCA mutation in China

Lei

Zhang²,

Zhang³

et al. 2022

Front. Oncol.

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Carriers with BRCA1/2 germline pathogenic variants are associated with a high risk of breast and ovarian cancers (also pancreatic and prostate cancers). While the spectrum on germline BRCA mutations among the Chinese population shows ethnic specificity, the identification of carriers with germline BRCA mutation before cancer onset is the most effective approach to protect them. This review focused on the current status of BRCA1/2 screening, the surveillance and prevention measures, and discussed the issues and potential impact of BRCA1/2 population screening in China. We conducted literature research on databases PubMed and Google Scholar, as well as Chinese databases CNKI and Wangfang Med Online database (up to 31 March 2022). Latest publications on germline BRCA1/2 prevalence, spectrum, genetic screening as well as carrier counseling, surveillance and prevention were captured where available. While overall 15,256 records were retrieved, 72 publications using germline BRCA1/2 testing were finally retained for further analyses. Germline BRCA1/2 mutations are common in Chinese patients with hereditary breast, ovarian, prostate and pancreatic cancers. Within previous studies, a unique BRCA mutation spectrum in China was revealed. Next-generation sequencing panel was considered as the most common method for BRCA1/2 screening. Regular surveillance and preventive surgeries were tailored to carriers with mutated-BRCA1/2. We recommend that all Chinese diagnosed with breast, ovarian, pancreatic or prostate cancers and also healthy family members, shall undergo BRCA1/2 gene test to provide risk assessment. Subsequently, timely preventive measures for mutation carriers are recommended after authentic genetic counseling.

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“…Similar mainstreaming has been trialled in other countries, 9,10 typically in cancers such as epithelial ovarian cancer, where approximately one quarter of patients have an underlying hereditary cancer syndrome. 11 A Malaysian study showed no significant differences between mainstreaming and formal genetics consultation in terms of satisfaction and psychosocial impact, with 80% of clinicians keen to integrate genetic testing into their practice.…”

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confidence: 95%

“…11 A Malaysian study showed no significant differences between mainstreaming and formal genetics consultation in terms of satisfaction and psychosocial impact, with 80% of clinicians keen to integrate genetic testing into their practice. 9 Adopting such an approach requires education and training of clinicians on genetics knowledge and counselling skills, as well as development of new guidelines and improving current clinical resources. This proposed hybrid approach involving both specialists and genetic counsellors (GCs) is a popular idea in the research setting.…”

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confidence: 99%

Challenges with mainstreaming genetic testing for metastatic prostate cancer treatment in Singapore

Chiang

Ngeow

2023

Ann Acad Med Singap

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Mainstreaming genetic counselling for genetic testing of BRCA1/2 in ovarian cancer patients in Malaysia (MaGIC study)

Cited by 4 publications

References 0 publications

Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia

Cost-effectiveness analysis of olaparib maintenance therapy for BRCA mutation ovarian cancer in the public sector in Malaysia

Overview on population screening for carriers with germline BRCA mutation in China

Challenges with mainstreaming genetic testing for metastatic prostate cancer treatment in Singapore

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