Michael P Lux1,2,3, Thomas Decker4, Eva Diana Runkel5, Alexander Niyazov6, Ruben G W Quek7, Norbert Marschner8, Nadia Harbeck9. 1. Kooperatives Brustzentrum Paderborn, Paderborn, Germany. 2. St. Josefs-Krankenhaus, Salzkotten, Germany. 3. Frauen- und Kinderklinik St. Louise, Paderborn, Germany. 4. Onkologie Ravensburg, Ravensburg, Germany. 5. Pfizer Pharma GmbH, Berlin, Germany. 6. Pfizer Inc., New York, New York, USA. 7. Pfizer Inc., San Francisco, California, USA. 8. iOMEDICO AG, Freiburg, Germany. 9. Brustzentrum, Frauenklinik und CCCLMU, LMU Klinikum, Universität München (LMU), Munich, Germany.
Abstract
Introduction: Diagnostic testing of germline mutations in breast cancer susceptibility genes 1 or 2 (gBRCA1/2) in patients with human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC; locally advanced or metastatic breast cancer) is necessary to assess eligibility for poly(ADP-ribose) polymerase inhibitors (PARPi). We investigated awareness, clinical practice, and the availability of gBRCA1/2 mutation testing in the German outpatient oncology setting. Methods: Office-based oncologists completed a 23-item online survey. Responses were evaluated collectively and by center type. Results: Of 50 oncologists, 33 and 17 were medical and gynecological oncologists, respectively. Oncologists treated a median of 65 (range 14-350) patients with ABC per year. The strongest decision factors to initiate gBRCA1/2 mutation testing were: patient's known family history of gBRCA1/2 mutation-related cancer(s), guideline recommendations, and triple-negative breast cancer (TNBC). In routine practice, 86% of oncologists tested for gBRCA1/2 mutations. Most oncologists (76-98%) reported testing patients with a known family history of gBRCA1/2 mutation-related cancer(s) irrespective of receptor status. For unknown family history, 92% of oncologists reported testing patients with advanced TNBC versus 30% for HR+/HER2- ABC. Oncologists (66%) rated the awareness of therapeutic relevance of gBRCA1/2 mutation testing for targeted treatment selection as good to satisfactory; 22% rated awareness as poor to in-sufficient. Conclusion: Diagnostic gBRCA1/2 mutation testing in patients with HER2- ABC is available and routinely performed in Germany's outpatient oncology setting. However, specific patient subgroups were not routinely tested despite therapeutic indications. Given PARPi availability, opportunities exist to improve testing rates especially for patients with HR+/HER2- ABC without a known family history of gBRCA1/2 mutation-related cancer(s).
Introduction: Diagnostic testing of germline mutations in breast cancer susceptibility genes 1 or 2 (gBRCA1/2) in patients with human epidermal growth factor receptor 2 negative (HER2-) advanced breast cancer (ABC; locally advanced or metastatic breast cancer) is necessary to assess eligibility for poly(ADP-ribose) polymerase inhibitors (PARPi). We investigated awareness, clinical practice, and the availability of gBRCA1/2 mutation testing in the German outpatient oncology setting. Methods: Office-based oncologists completed a 23-item online survey. Responses were evaluated collectively and by center type. Results: Of 50 oncologists, 33 and 17 were medical and gynecological oncologists, respectively. Oncologists treated a median of 65 (range 14-350) patients with ABC per year. The strongest decision factors to initiate gBRCA1/2 mutation testing were: patient's known family history of gBRCA1/2 mutation-related cancer(s), guideline recommendations, and triple-negative breast cancer (TNBC). In routine practice, 86% of oncologists tested for gBRCA1/2 mutations. Most oncologists (76-98%) reported testing patients with a known family history of gBRCA1/2 mutation-related cancer(s) irrespective of receptor status. For unknown family history, 92% of oncologists reported testing patients with advanced TNBC versus 30% for HR+/HER2- ABC. Oncologists (66%) rated the awareness of therapeutic relevance of gBRCA1/2 mutation testing for targeted treatment selection as good to satisfactory; 22% rated awareness as poor to in-sufficient. Conclusion: Diagnostic gBRCA1/2 mutation testing in patients with HER2- ABC is available and routinely performed in Germany's outpatient oncology setting. However, specific patient subgroups were not routinely tested despite therapeutic indications. Given PARPi availability, opportunities exist to improve testing rates especially for patients with HR+/HER2- ABC without a known family history of gBRCA1/2 mutation-related cancer(s).
Authors: J Ettl; R G W Quek; K-H Lee; H S Rugo; S Hurvitz; A Gonçalves; L Fehrenbacher; R Yerushalmi; L A Mina; M Martin; H Roché; Y-H Im; D Markova; H Bhattacharyya; A L Hannah; W Eiermann; J L Blum; J K Litton Journal: Ann Oncol Date: 2018-09-01 Impact factor: 32.976
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Authors: J K Litton; S A Hurvitz; L A Mina; H S Rugo; K-H Lee; A Gonçalves; S Diab; N Woodward; A Goodwin; R Yerushalmi; H Roché; Y-H Im; W Eiermann; R G W Quek; T Usari; S Lanzalone; A Czibere; J L Blum; M Martin; J Ettl Journal: Ann Oncol Date: 2020-08-20 Impact factor: 32.976
Authors: Karoline B Kuchenbaecker; John L Hopper; Daniel R Barnes; Kelly-Anne Phillips; Thea M Mooij; Marie-José Roos-Blom; Sarah Jervis; Flora E van Leeuwen; Roger L Milne; Nadine Andrieu; David E Goldgar; Mary Beth Terry; Matti A Rookus; Douglas F Easton; Antonis C Antoniou; Lesley McGuffog; D Gareth Evans; Daniel Barrowdale; Debra Frost; Julian Adlard; Kai-Ren Ong; Louise Izatt; Marc Tischkowitz; Ros Eeles; Rosemarie Davidson; Shirley Hodgson; Steve Ellis; Catherine Nogues; Christine Lasset; Dominique Stoppa-Lyonnet; Jean-Pierre Fricker; Laurence Faivre; Pascaline Berthet; Maartje J Hooning; Lizet E van der Kolk; Carolien M Kets; Muriel A Adank; Esther M John; Wendy K Chung; Irene L Andrulis; Melissa Southey; Mary B Daly; Saundra S Buys; Ana Osorio; Christoph Engel; Karin Kast; Rita K Schmutzler; Trinidad Caldes; Anna Jakubowska; Jacques Simard; Michael L Friedlander; Sue-Anne McLachlan; Eva Machackova; Lenka Foretova; Yen Y Tan; Christian F Singer; Edith Olah; Anne-Marie Gerdes; Brita Arver; Håkan Olsson Journal: JAMA Date: 2017-06-20 Impact factor: 56.272
Authors: M E Robson; N Tung; P Conte; S-A Im; E Senkus; B Xu; N Masuda; S Delaloge; W Li; A Armstrong; W Wu; C Goessl; S Runswick; S M Domchek Journal: Ann Oncol Date: 2019-04-01 Impact factor: 32.976
Authors: Hope S Rugo; Johannes Ettl; Sara A Hurvitz; Anthony Gonçalves; Kyung-Hun Lee; Louis Fehrenbacher; Lida A Mina; Sami Diab; Natasha E Woodward; Rinat Yerushalmi; Annabel Goodwin; Joanne L Blum; Miguel Martin; Ruben G W Quek; Iulia Cristina Tudor; Helen Bhattacharyya; Eric Gauthier; Jennifer K Litton; Wolfgang Eiermann Journal: JNCI Cancer Spectr Date: 2019-10-21