"In our sample, nearly 10% of patients [with prostate cancer] had a gene variant that made them eligible for effective new therapies, with faster results than traditional referral for genetic testing and counseling,” said Maria I. Carlo, MD.
A new genetic testing model based on oncologist referrals was found to improve time to test results compared with traditional models for patients with prostate cancer, according to findings published in the Journal of Urology.1
"Oncologist-initiated germline genetic testing is a feasible approach to testing prostate cancer patients. In our sample, nearly 10% of patients had a gene variant that made them eligible for effective new therapies, with faster results than traditional referral for genetic testing and counseling,” said senior author Maria I. Carlo, MD, in a news release on the findings.2 Carlo is a medical oncologist at Memorial Sloan Kettering Center in New York.
The multicenter, single-arm, prospective trial (NCT02917798) assessed an oncologist-initiated referral process for patients with prostate cancer. Patients appropriate for genetic testing were identified by oncologists during routine office appointments rather than through the traditional referral process, and they were then provided pretest education in the form of a brochure and video. After pretest materials were reviewed, 501 patients agreed to undergo testing and provided a blood and saliva sample for analysis.
Of the 501 participants, 51 (10.2%) tested positive for having at least 1 pathogenic or likely pathogenic variant (PV). Among those patients, 48 were characterized as having advanced disease, and a change of treatment was discussed with 22 (45.8%) of those patients based on the results of their genetic test. At least 1 variant of uncertain significance (VUS) was identified in 72 (14.4%) patients.
Test results were delivered and discussed with patients within a median of 23 days from enrollment and 20 days following the collection of blood and saliva samples. This compares favorably with the traditional model, which typically have scheduling wait times of 2 weeks to 4 months, and then a result time frame of another 2 to 4 weeks.
Upon completion of the study, participants were given a questionnaire regarding their satisfaction with pretest education and the clinical decisions resulting from their genetic test results. Average satisfaction with pretest education was 15.5 on a 4-20 scale. Satisfaction results did not differ based on subsequent result type (PV, VUS, or negative result) or participant-level factors, with the exception of level of education. Those with less than a college degree and those with a college degree reported higher satisfaction with the pretest compared with those with a postgraduate degree.
Average satisfaction with the decision to undergo genetic testing was 17.1. Results did not differ based on participant-level factors or subsequent result of their test.
"This study demonstrated the feasibility and clinical impact of utilizing an alternative model of genetic testing in individuals with advanced prostate cancer. This process and education material could serve as a model to other institutions experiencing a high volume of prostate cancer patients,” concluded the study authors.
1. Breen KE, Symecko H, Spielman K, et al. Clinical impact of a rapid genetic testing model for advanced prostate cancer patients. J Urol. 2023 Mar 28;101097JU0000000000003186. doi:10.1097/JU.0000000000003186.
2. Rapid genetic testing targets advanced prostate cancer patients for new treatments. News release. Wolters Kluwer Health: Lippincott. March 29, 2023. Accessed March 31, 2023. https://www.newswise.com/articles/rapid-genetic-testing-targets-advanced-prostate-cancer-patients-for-new-treatments?sc=mwhr&xy=10016681