Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer

Nicoletta Colombo, Gloria Huang, Giovanni Scambia, Eva Chalas, Sandro Pignata, James Fiorica, Linda Vanle, Sharad A Ghamande, Santiago González-Santiago, Isabel Bover, Begoña Graña Suárez, Andrew Green, Philippe Huot-Marchand, Yann Bourhis, Sudeep Karve, Christopher Blakeley

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose There is a growing demand for BRCA1/2 mutation (BRCAm) testing in patients with ovarian cancer; however, the limited number of genetic counselors presents a potential barrier. To facilitate more widespread BRCAm testing in ovarian cancer, pretest counseling by the oncology team could shorten testing turnaround times and ease the pressure on genetic counselors. Patients and Methods The prospective, observational Evaluating a Streamlined Onco-genetic BRCA Testing and Counseling Model Among Patients With Ovarian Cancer (ENGAGE) study evaluated a streamlined, oncologist-led BRCAm testing pathway. The analysis population comprised 700 patients with ovarian cancer at 26 sites in the United States, Italy, and Spain. The primary objectives were to assess turnaround time and, using questionnaires, to evaluate stakeholder satisfaction (patients, oncologists, and geneticists or genetic counselors) with the oncologist-led BRCAm testing pathway. Results The median overall turnaround time was 9.1 weeks (range, 0.9 to 37.1 weeks), with median turnaround times in the United States, Italy, and Spain of 4.1 weeks (range, 0.9 to 37.1 weeks), 20.4 weeks (range, 2.9 to 35.4 weeks), and 12.0 weeks (range, 2.0 to 36.7 weeks), respectively. Patient satisfaction with the oncologist-led BRCAm testing pathway was high, with . 99% of patients expressing satisfaction with pre- and post-BRCAm test counseling. Oncologist satisfaction with the BRCAm testing pathway was also high, with . 80% agreeing that the process for performing BRCAm testing worked well and that counseling patients on BRCAm testing was an efficient use of their time. Oncologists expressed higher levels of satisfaction with the BRCAm testing pathway than did geneticists or genetic counselors. Conclusion The results of the ENGAGE study demonstrate that an oncologist-led BRCAm testing process is feasible in ovarian cancer. Development of local BRCAm testing guidelines similar to the one used in this study could allow faster treatment decisions and better use of resources in the management of patients with ovarian cancer.

Original languageEnglish (US)
Pages (from-to)1300-1307
Number of pages8
JournalJournal of Clinical Oncology
Volume36
Issue number13
DOIs
StatePublished - May 1 2018

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Ovarian Neoplasms
Counseling
Mutation
Patient Satisfaction
Spain
Italy
Oncologists
Genetic Counseling
Genetic Testing
Guidelines
Pressure
Counselors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer. / Colombo, Nicoletta; Huang, Gloria; Scambia, Giovanni; Chalas, Eva; Pignata, Sandro; Fiorica, James; Vanle, Linda; Ghamande, Sharad A; González-Santiago, Santiago; Bover, Isabel; Suárez, Begoña Graña; Green, Andrew; Huot-Marchand, Philippe; Bourhis, Yann; Karve, Sudeep; Blakeley, Christopher.

In: Journal of Clinical Oncology, Vol. 36, No. 13, 01.05.2018, p. 1300-1307.

Research output: Contribution to journalArticle

Colombo, N, Huang, G, Scambia, G, Chalas, E, Pignata, S, Fiorica, J, Vanle, L, Ghamande, SA, González-Santiago, S, Bover, I, Suárez, BG, Green, A, Huot-Marchand, P, Bourhis, Y, Karve, S & Blakeley, C 2018, 'Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer', Journal of Clinical Oncology, vol. 36, no. 13, pp. 1300-1307. https://doi.org/10.1200/JCO.2017.76.2781
Colombo, Nicoletta ; Huang, Gloria ; Scambia, Giovanni ; Chalas, Eva ; Pignata, Sandro ; Fiorica, James ; Vanle, Linda ; Ghamande, Sharad A ; González-Santiago, Santiago ; Bover, Isabel ; Suárez, Begoña Graña ; Green, Andrew ; Huot-Marchand, Philippe ; Bourhis, Yann ; Karve, Sudeep ; Blakeley, Christopher. / Evaluation of a Streamlined Oncologist-Led BRCA Mutation Testing and Counseling Model for Patients With Ovarian Cancer. In: Journal of Clinical Oncology. 2018 ; Vol. 36, No. 13. pp. 1300-1307.
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abstract = "Purpose There is a growing demand for BRCA1/2 mutation (BRCAm) testing in patients with ovarian cancer; however, the limited number of genetic counselors presents a potential barrier. To facilitate more widespread BRCAm testing in ovarian cancer, pretest counseling by the oncology team could shorten testing turnaround times and ease the pressure on genetic counselors. Patients and Methods The prospective, observational Evaluating a Streamlined Onco-genetic BRCA Testing and Counseling Model Among Patients With Ovarian Cancer (ENGAGE) study evaluated a streamlined, oncologist-led BRCAm testing pathway. The analysis population comprised 700 patients with ovarian cancer at 26 sites in the United States, Italy, and Spain. The primary objectives were to assess turnaround time and, using questionnaires, to evaluate stakeholder satisfaction (patients, oncologists, and geneticists or genetic counselors) with the oncologist-led BRCAm testing pathway. Results The median overall turnaround time was 9.1 weeks (range, 0.9 to 37.1 weeks), with median turnaround times in the United States, Italy, and Spain of 4.1 weeks (range, 0.9 to 37.1 weeks), 20.4 weeks (range, 2.9 to 35.4 weeks), and 12.0 weeks (range, 2.0 to 36.7 weeks), respectively. Patient satisfaction with the oncologist-led BRCAm testing pathway was high, with . 99{\%} of patients expressing satisfaction with pre- and post-BRCAm test counseling. Oncologist satisfaction with the BRCAm testing pathway was also high, with . 80{\%} agreeing that the process for performing BRCAm testing worked well and that counseling patients on BRCAm testing was an efficient use of their time. Oncologists expressed higher levels of satisfaction with the BRCAm testing pathway than did geneticists or genetic counselors. Conclusion The results of the ENGAGE study demonstrate that an oncologist-led BRCAm testing process is feasible in ovarian cancer. Development of local BRCAm testing guidelines similar to the one used in this study could allow faster treatment decisions and better use of resources in the management of patients with ovarian cancer.",
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AU - Colombo, Nicoletta

AU - Huang, Gloria

AU - Scambia, Giovanni

AU - Chalas, Eva

AU - Pignata, Sandro

AU - Fiorica, James

AU - Vanle, Linda

AU - Ghamande, Sharad A

AU - González-Santiago, Santiago

AU - Bover, Isabel

AU - Suárez, Begoña Graña

AU - Green, Andrew

AU - Huot-Marchand, Philippe

AU - Bourhis, Yann

AU - Karve, Sudeep

AU - Blakeley, Christopher

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N2 - Purpose There is a growing demand for BRCA1/2 mutation (BRCAm) testing in patients with ovarian cancer; however, the limited number of genetic counselors presents a potential barrier. To facilitate more widespread BRCAm testing in ovarian cancer, pretest counseling by the oncology team could shorten testing turnaround times and ease the pressure on genetic counselors. Patients and Methods The prospective, observational Evaluating a Streamlined Onco-genetic BRCA Testing and Counseling Model Among Patients With Ovarian Cancer (ENGAGE) study evaluated a streamlined, oncologist-led BRCAm testing pathway. The analysis population comprised 700 patients with ovarian cancer at 26 sites in the United States, Italy, and Spain. The primary objectives were to assess turnaround time and, using questionnaires, to evaluate stakeholder satisfaction (patients, oncologists, and geneticists or genetic counselors) with the oncologist-led BRCAm testing pathway. Results The median overall turnaround time was 9.1 weeks (range, 0.9 to 37.1 weeks), with median turnaround times in the United States, Italy, and Spain of 4.1 weeks (range, 0.9 to 37.1 weeks), 20.4 weeks (range, 2.9 to 35.4 weeks), and 12.0 weeks (range, 2.0 to 36.7 weeks), respectively. Patient satisfaction with the oncologist-led BRCAm testing pathway was high, with . 99% of patients expressing satisfaction with pre- and post-BRCAm test counseling. Oncologist satisfaction with the BRCAm testing pathway was also high, with . 80% agreeing that the process for performing BRCAm testing worked well and that counseling patients on BRCAm testing was an efficient use of their time. Oncologists expressed higher levels of satisfaction with the BRCAm testing pathway than did geneticists or genetic counselors. Conclusion The results of the ENGAGE study demonstrate that an oncologist-led BRCAm testing process is feasible in ovarian cancer. Development of local BRCAm testing guidelines similar to the one used in this study could allow faster treatment decisions and better use of resources in the management of patients with ovarian cancer.

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