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. 2020 Feb 25;10(1):3390.
doi: 10.1038/s41598-020-60149-5.

Oncologist-led BRCA 'mainstreaming' in the ovarian cancer clinic: A study of 255 patients and its impact on their management

Megan Rumford  1 , Mark Lythgoe  2 , Iain McNeish  3 , Hani Gabra  3 , Laura Tookman  2 , Nazneen Rahman  4   5 , Angela George #  6 , Jonathan Krell #  3
Affiliations

Oncologist-led BRCA 'mainstreaming' in the ovarian cancer clinic: A study of 255 patients and its impact on their management

Megan Rumford et al. Sci Rep. .

Abstract

Although guidelines recommend BRCA testing for all women with non-mucinous epithelial ovarian cancer, there is significant variability in access to testing across the UK. A germline BRCA mutation (BRCAm) in ovarian cancer patients provides prognostic and predictive information and influences clinical management, such as the use of PARP inhibitors, which have demonstrated a progression-free survival benefit in the BRCAm cohort. Additionally, the finding of a BRCAm has significant implications for patients and their families in terms of cancer risk and prevention. We studied the impact of a newly-formed, oncologist-led 'mainstreaming' germline BRCA testing pathway in 255 ovarian cancer patients at Imperial College NHS Trust. Prior to the establishment of 'mainstreaming', uptake of germline BRCA testing was 14% with a mean turnaround time of 148.2 calendar days. The 'mainstreaming' approach led to a 95% uptake of germline BRCA testing and a mean turnaround time of 20.6 days. Thirty-four (13.33%) BRCAm patients were identified. At the time of data collection nine BRCAm patients had received a PARP inhibitor off-trial, three had entered a PARP inhibitor trial and 5 were receiving platinum-based chemotherapy with a plan to receive PARP inhibitor maintenance. This study provides further evidence of the impact of oncologist-led 'mainstreaming' programs.

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Conflict of interest statement

Summary of competing financial and non-financial interests: M.R. was employed by AstraZeneca throughout the duration of this project. H.G. has received honoraria from AstraZeneca, was employed at Imperial College at the time that this work was undertaken but now works for AstraZeneca whilst also still holding a position of employment at Imperial College. A.G. has received honoraria paid to departmental research account from AstraZeneca, Roche and Tesaro. I.M. has received honoraria from Clovis Oncology, Tesaro, AstraZeneca and Takeda, and has also received grants from AstraZeneca, outside the submitted work. J.K. has received honoraria from Clovis Oncology, Tesaro and AstraZeneca, outside the submitted work. N.R. is a non-executive director of AstraZeneca. L.T. has received Tesaro and AstraZeneca, outside the submitted work. M.L. has no disclosures. None of the aforementioned companies had any input into the study design, data collection, reporting or preparation of the manuscript.

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