Using patient-reported outcomes to assess the impact of germline genetic testing on prostate cancer patients.

Authors

null

Sarah M. Nielsen

Invitae, San Francisco, CA

Sarah M. Nielsen , Neal D. Shore , Mukaram Gazi , Christopher Michael Pieczonka , Sean Heron , David J Cahn , Laurence Belkoff , Aaron D. Berger , Brian Mazzarella , Joseph Veys , David Morris , Richard Bevan-Thomas , Alexander Engelman , Paul Dato , Robert Cornell , David R Wise , Mary Kay Hardwick , Brandie Heald , Robert Luke Nussbaum , Edward D. Esplin

Organizations

Invitae, San Francisco, CA, Carolina Urologic Research Center and Atlantic Urology Clinics, Myrtle Beach, SC, University Urology Associates, Howell Township, NJ, Associated Medical Professionals of NY, Syracuse, NY, AUI Health—Advanced Urology Institute, St Petersburg, FL, Colorado Urology, Golden, CO, Midlantic Urology, Bala Cynwyd, PA, Associated Urological Specialists, Chicago Ridge, IL, Urology Austin, Austin, TX, North Georgia Urology Center, Dalton, GA, Urology Associates, Nashville, TN, Urology Partners, Arlington, TX, Tampa General Cancer Institute, Tampa, FL, Unio Health Partners, San Diego, CA, Urosurgery Houston, Houston, TX, NYU Langone Perlmutter Cancer Center, New York, NY, Targeted Medical Education, Cupertino, CA, Invitae, San Leandro, CA

Research Funding

Pharmaceutical/Biotech Company
Invitae Corp.

Background: Germline genetic testing (GGT) affords prostate cancer (PCa) patients (pts) opportunities for targeted therapies, prevention and cascade testing. Patient-reported outcomes (PRO) can evaluate physician effectiveness in promoting patient test comprehension and clinical decision making, which are critical to realize the benefits of GGT. PROs from a large PCa GGT study among urologists were analyzed. Methods: A prospective study enrolled unselected PCa pts from 15 primarily community urology practices. Pts underwent 84-gene GGT, with PROs collected via electronic or paper surveys >1-month post GGT. Differences in proportions were determined using two-tailed Fisher’s exact test and significance was set at <0.05. Results: PROs were completed by 561/982 (57%) pts (85% white, 82% non-metastatic, median age at testing 70 years). 59 (11%) pts had positive results, 247 (44%) negative and 255 (46%) variants of uncertain significance (VUS). 72% accurately recalled their result (range, 50% [VUS]-93% [negative]). 66% of positive pts, 80% negative and 54% VUS correctly understood if their result was associated with cancer risk or not. 72% of positive pts had or planned to complete ≥1 physician recommendations, significantly more than negative or VUS pts (Table). Most pts reported that their test result reduced their concerns (40%) or did not impact their level of concern (52%) regarding their PCa diagnosis, treatment or followup. 19% of positive pts reported increased concern. Conclusions: GGT for PCa was deployed without causing undue concern and resulted in adherence to physician recommendations. Still, there is room for improvement in how test results (especially VUS) and recommendations are communicated to pts.

Uptake of physician recommendations among PCa position.

Recommendation Total
(n=561)
%*Positive
(n=59)
%*Negative
(n=247)
%*VUS
(n=255)
%*
No response25523115125
No additional recommendations made by physician228431018127639136
See a genetic counselor to further understand my test results622010211993322
New treatment plan72239192613372
New follow up plan311036157139
Meet with a specialist to follow up on non-PCa concerns2384984117
Recommend family members be tested and/or see genetic counselor702325531992617
Completed or plan to complete ≥1 of the above recommendations 172563472^56288254^

* Denominator excludes pts from rows 1 and 2. ^ Significant difference between positive and negative/VUS pts and between VUS and negative pts.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Prevention, Risk Reduction, and Hereditary Cancer

Track

Prevention, Risk Reduction, and Genetics

Sub Track

Germline Genetic Testing

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 10607)

DOI

10.1200/JCO.2023.41.16_suppl.10607

Abstract #

10607

Poster Bd #

240

Abstract Disclosures

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