Novel BRCA testing model reduces wait, increases patient satisfaction

COPENHAGEN, Denmark — A novel BCRA1/2 testing and counseling model expedited time to receive germline testing results and increased patient and staff satisfaction, according to interim results of the prospective, observational ENGAGE study presented at the European Society for Medical Oncology Congress.

“Targeted therapies mean that germline BRCA mutation testing and genetic counseling are becoming routine in ovarian cancer management,” Giovanni Scambia, MD, of the department of gynecologic oncology at Catholic University of the Sacred Heart in Rome, Italy, and colleagues wrote.

Scambia and colleagues implemented a BRCA testing and counseling model — first used at Institute of Cancer Research and Royal Marsden Hospital in London — across 11 sites in the United States, eight in Italy and seven in Spain, comprising 710 adults with epithelial ovarian, fallopian tube or primary peritoneal cancers.

The interim analysis included data from 444 patients (U.S., n = 297; Europe, n = 147) with a mean age of 63.7 years (standard deviation [SD], 10.6). Thirty-eight percent of patients were newly diagnosed with cancer and 38% had a family history of breast or ovarian cancer.

Median time since diagnosis was 0.8 years.

All physicians completed training on BRCA mutation counseling. Oncologists (40%) and nurses (56%) in the United States and oncologists in Europe then provided pre-BRCA test counseling to patients. One patient requested additional pretest counseling.

The mean turnaround time from initial counseling to BRCA test results or oncogenetic counseling was 6.7 weeks (SD, 4.5) overall, and 5.1 weeks (SD, 3.7) in the United States and 10 (SD, 4.2) in the European Union.

Ninety-one percent of BRCA testing was performed in a central laboratory. Ten percent of patients were found to harbor a BRCA mutation.

Mean scores of patient-reported fulfillment of expectations and overall satisfaction were less than 3.7 for pretesting and were 4 for post-BRCA testing. Ninety-two percent of patients reported they were satisfied to have the genetic test at an already scheduled appointment rather than at a new appointment.

More than 80% of oncologists reported that the testing process worked well and that counseling patients was an efficient use of time.

These results demonstrate “the potential for quicker treatment decisions and better use of resources,” the researchers wrote. “The time to receive the BRCA mutation test result was the major variable.” – by Alexandra Todak

Reference:

Scambia G, et al. Abstract LBA34. Presented at: European Society for Medical Oncology Congress; Oct. 7-11, 2016; Copenhagen, Denmark.

Disclosure: AstraZeneca funded this study. Scambia reports no relevant financial disclosures. Other researchers report honoraria, research funding and travel accommodations from; speakers bureau, employment and advisory board roles with; and stock ownership in AstraZeneca.