Value of multigene panel retesting of families with BRCA1/2 mutation-negative hereditary breast and ovarian cancer (HBOC).

Authors

null

Ekaterina Meshoulam Nikolaeva

Mutua Terrassa, Terrassa, Spain

Ekaterina Meshoulam Nikolaeva , Raul Terés , Daniela Camacho , Aida Bujosa , Maria Borrell , Pablo Gallardo , Berta Martin , Nuria Calvo , Consol Lopez , Rosa Alfonso , Carla Sola , Monia Cornet , Nuria Cliville , Adriana Lasa , Ariadna Tibau , Cristina Arqueros , Agusti Barnadas , Teresa Ramon y Cajal

Organizations

Mutua Terrassa, Terrassa, Spain, Hospital de Sant Pau, Barcelona, Spain, Hospital Sant Pau, Barcelona, Spain, Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, Department of Medical Oncology, Hospital de Sant Pau, Barcelona, Spain, Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, Medical Oncology Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institut Sant Pau (IIB Sant Pau) and Universitat Autònoma de Barcelona, Barcelona, Spain

Research Funding

No funding received
None

Background: Despite the use of clinical eligibility criteria and mutation predictive models, a great proportion of families are negative for germline mutations in BRCA1/2 genes. Traditionally, risk assessment of inconclusive results included the recommendation of high-risk surveillance protocol, the update of incident cancer cases in the family and the consideration of additional testing to rule out the possibility of phenocopy. More recently, next generation sequencing multigene panels have become a standard practice in cancer genetics clinics worldwide. We addressed the value of multigene panel retesting of BRCA1/2 negative HBOC families in our institution. Methods: After genetic counseling session and informed consent, a total of 137 individuals (119 probands and 18 extra cancer-affected relatives) from distinct BRCA1/2 negative families were retested using a panel containing 11 breast and ovarian cancer susceptibility genes (BRCA1/2, PALB2, ATM, CHEK2, PTEN, TP53, STK11, BRIP1, RAD51C, RAD51D). Results: According to the BOADICEA model, the remaining probability of mutation in BRCA1/2 or PALB2 genes in our cohort was 5.5% (0.1-61). The reasons for considering retesting were the addition of any incident cancer diagnosis in 33 cases (24%), a prior study with a low sensitivity screening technique (dHPLC) in 6 families (5%) and the expansion of the study to other putative breast and ovarian susceptibility genes in 98 families (71%). Overall, 3 pathogenic (2 BRCA2, 1 CHEK2) and 8 likely pathogenic variants (1 BRCA2, 4 CHEK2 and 3 ATM) were found. The prevalence was 8%. The detection rate among 19 families with a > 10% remaining probability of mutation in BRCA1/2 and PALB2 genes was 26%. The 3 clinically significant variants in BRCA2 were detected in 2 families and 1 updated cancer family history (BOADICEA remaining probability of 59, 61 and 12%, respectively). Cascade testing was subsequently done in 15 relatives resulting 8 in mutation carriers and 9 true negatives. Conclusions: Our results support the value of updating cancer incident cases and considering expanded panels in selected families.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Cancer Prevention, Risk Reduction, and Genetics

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Germline Genetic Testing

Citation

J Clin Oncol 38: 2020 (suppl; abstr 1582)

DOI

10.1200/JCO.2020.38.15_suppl.1582

Abstract #

1582

Poster Bd #

74

Abstract Disclosures

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