Genetic counseling and testing offered by a patient’s oncologist was feasible and deemed satisfactory by clinicians and patients with metastatic prostate cancer, according to a study published in JCO Oncology Practice (2020. doi:10.1200/OP.20.00399).
“To identify the approximately 12% with inherited cancer predisposition, all men with metastatic prostate cancer should be offered germline genetic testing. This guides treatment choices and impacts cancer prevention in the family,” wrote Tahlia Scheinberg, MBBS, University of Sydney, Camperdown, New South Wales, Australia, and colleagues.
“Limited genetic services globally present a barrier to testing,” they continued.
This study tested a potential solution—“mainstreaming” of genetic counseling and testing into a patient’s regular oncology appointment—at 3 sites in Australia. Patients received germline genetic testing on their saliva/blood.
Testing of 63 men revealed 2 variants of BRCA2, one NBN variant, and one MSH6 variant.
Feedback from 50 patients and 9 clinicians, showed high rates of satisfaction with the mainstreaming of genetic counseling and testing. Overall, all patients were satisfied to have had testing at all, 98% (46 of 47) were satisfied to have had testing at their usual oncology appointment, and all were satisfied to receive results from their usual specialist, rather than a separate genetics appointment.
All clinicians were satisfied, and 88% felt confident, with the mainstreaming, according to the study. Moreover, mainstreaming required 87% fewer genetic consultations compared with traditional genetic counseling, noted researchers, who declared the practice resource efficient.
“This study demonstrates that mainstreaming of men with [metastatic prostate cancer] is feasible, resource efficient, and satisfactory for clinicians and patients. Widespread implementation as standard of care would facilitate timely access to genetic testing for men with [metastatic prostate cancer],” Dr Scheinberg and colleagues concluded.—Jolynn Tumolo
