Multi-disciplinary summit on genetics services for women with gynecologic cancers: A Society of Gynecologic Oncology White Paper

Randall, Leslie M.; Pothuri, Bhavana; Swisher, Elizabeth M.; Diaz, John P.; Buchanan, Adam H.; Witkop, Catherine; Powell, C. Bethan; Smith, Ellen Blair; Robson, Mark E.; Boyd, Jeff; Coleman, Robert L.; Lu, Karen H.

doi:10.1016/j.ygyno.2017.06.002

Cited by 96 publications

(65 citation statements)

References 56 publications

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“…Despite national guidelines suggesting 100% GT for OVCA patients, the national average is 20% to 30%. 4 Identifying predictors of genetics referral among OVCA patients has the potential to increase guideline-concordant care.…”

Section: Discussionmentioning

confidence: 99%

“…3 Knowledge of genetic mutations may also impact clinical trial eligibility and enrollment as targeted therapeutic indications increase. 4 Additionally, given improved survival among OVCA patients, BRCA1/2 testing is important to identify those at increased risk for secondary malignancies (eg, breast cancer). 3 Finally, if a BRCA1/2 mutation is identified, cascade testing can be initiated to identify mutations in at-risk relatives.…”

Section: Introductionmentioning

confidence: 99%

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Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute‐Comprehensive Cancer Center

et al. 2019

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Germline mutations (eg, BRCA1/2) have prognostic and treatment implications for ovarian cancer (OVCA) patients. Thus, national guidelines recommend genetic testing for OVCA patients. The present study examines patterns and predictors of genetics referral in OVCA patients. Electronic medical record data were abstracted retrospectively from 557 OVCA patients treated from 1 January 2001 to 31 December 2015.Logistic regression models identified sociodemographic characteristics, disease/treatment characteristics, family history data, provider characteristics, and survival data that predicted genetics referral. Overall, 27.5% of patients received referral. Eleven variables predicting referral were selected during stepwise regression: younger age, White race, not having private insurance, professional school education, year of OVCA diagnosis, platinum sensitivity, female gynecologic oncologist, chemotherapy administered by a gynecologic oncologist, clinical trial enrollment, longer overall survival, and family history of OVCA. Genetics referral among OVCA patients was similar to rates reported nationwide. Unique predictive factors will contribute to quality improvement and should be validated at a multi-institutional level to ensure guideline concordant care is provided to all OVCA patients. Future research should identify both patient-level and provider-level factors associated with genetics referral. K E Y W O R D S

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute‐Comprehensive Cancer Center

et al. 2019

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“…From our study results, it appears that the more recent updates to international guidelines that recommend testing of all OC patients (e.g. NCCN, ACOG and SGO), as well as patients with an FH of prostate and/or pancreatic cancer, will likely require further local evidence and experience before they are fully supported and absorbed. For example, for patients with a personal history of prostate and pancreatic cancer, the relevance of the associations between prostate and pancreatic cancer and BC and OC in Asian ethnicities may need to be confirmed by additional evidence in the literature.…”

Section: Discussionmentioning

confidence: 96%

BRCA mutation testing for ovarian cancer in the context of available targeted therapy: Survey and consensus of Hong Kong specialists

Kwong

Cheng

Hsue³

et al. 2019

Asia-Pac J Clncl Oncology

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Aims BRCA mutation (BRCAmut) testing is an important tool for the risk assessment, prevention and early diagnosis of breast cancer (BC) and ovarian cancer (OC), and more recently, for determining patient susceptibility to targeted therapy. This study assessed the current BRCAmut testing patterns and explored physicians’ perspectives on the utilities and optimal sequencing of the testing, in order to facilitate and standardize testing practices. Methods Medical specialists in BC and OC in Hong Kong were invited to complete a questionnaire on BRCAmut testing practices. A panel of specialists with extensive BRCAmut testing experience was also convened to develop consensus statements on testing, using the Delphi method and an anonymous electronic voting system. Results The survey respondents (n = 71) recognized family history (FH) of BC and/or OC and an early age of onset as key factors for referring BRCAmut testing. The proportion of respondents who would test all OCs regardless of FH or age, as per the recent international guideline, was low (28.2%). The largest hurdles to testing were the cost, as well as the availability of next‐generation sequencing‐accredited testing and genetic counseling facilities. The panelists suggested that the sequence of somatic testing followed by germline testing may help address both the imminent need of treatment planning and longer term hereditary implications. The potential emotional and financial burdens of BRCAmut testing should be weighed against the potential therapeutic benefits, and the type and timing of testing personalized. Conclusions Accessibility of BRCAmut testing to all at‐risk individuals will be achievable through improvements in testing affordability, as well as widened availability of accredited testing and genetic counseling facilities.

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“…The Traceback program could offer a valuable opportunity to reach families from different racial, ethnic, and socio-economic groups who historically have not sought or been offered genetic counseling and testing and thereby contribute to a reduction in health disparities in women with germline BRCA mutations. The workshop assembled international experts in genetics, medical and gynecological oncology, clinical psychology, epidemiology, genomics, cost-effectiveness modeling, pathology, bioethics, and patient advocacy to identify factors to consider when undertaking a Traceback program to achieve an interdisciplinary perspective [113][114][115].…”

Section: Potential Obstacles and Implementationmentioning

confidence: 99%

The Role of Genetic Counseling in Gynecological Oncology

Comparetto¹,

Dupré²,

Borruto³

2019

obm genet

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Background: Clinical or medical genetics deals with the study and diagnosis of genetic diseases. It is oriented to the formulation of the clinical diagnosis of genetic diseases and genetic counseling to evaluate the possible reproductive risk for the patient and his/her family. The geneticists here play a role in the diagnosis and prevention of some of the diseases occurring most frequently, such as cancer and cardiovascular diseases. Methods: State-of-the-art through literature review. Results: Genetic counseling helps consultants make decisions regarding the possibility of developing and/or transmitting genetic diseases, to evaluate the possible choices that can be made once genetic testing has been carried out and its result is known (possible therapies, voluntary pregnancy interruption, etc.). The decision on what to do is always autonomous to the consultants and the doctor or, a qualified professional figure has no role in it. Genetic

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Multi-disciplinary summit on genetics services for women with gynecologic cancers: A Society of Gynecologic Oncology White Paper

Cited by 96 publications

References 56 publications

Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute‐Comprehensive Cancer Center

Patterns and predictors of genetic referral among ovarian cancer patients at a National Cancer Institute‐Comprehensive Cancer Center

BRCA mutation testing for ovarian cancer in the context of available targeted therapy: Survey and consensus of Hong Kong specialists

The Role of Genetic Counseling in Gynecological Oncology

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