Introducing the latest insights in BRCA testing for ovarian cancer
All women with epithelial ovarian cancer should be BRCA tested, as its used to reveal important information for the evaluation and management of the disease.
Who needs early BRCA testing?
Testing all patients with ovarian cancer for a BRCA mutation is a crucial component of their medical management and can help inform treatment strategies.2,3
All women with epithelial ovarian cancer should be BRCA tested
Why do I need to perform early BRCA testing?
BRCA mutation testing can reveal important information about potential treatment options, familial risk, and risk of recurrence of BRCA-related cancers such as ovarian cancer.1,2
Test routinely to inform treatment decisions
How do I conduct BRCA testing?
In ovarian cancer, testing of BRCA1 and BRCA2 can be performed with tumour and/or blood samples.4 Appropriately testing and quickly returning results can give patients the opportunity to receive the most appropriate treatments based on their BRCA mutation status.5
Additional tests may be conducted, including genomic instability tests that identify tumours with genomic aberrations that are characteristic of homologous recombination deficiency.4,6
Appropriate testing can guide personalised treatment decisions7
How do I interpret the results of a BRCA test and what does it mean for patients?
A tumour test can identify both tumour and germline BRCA mutations to guide treatment decisions. However, it is unable to distinguish the origin of the BRCA mutation; a follow-up blood test is recommended to determine whether the mutation is of germline origin.5,8,9
Genetic test results can be challenging to interpret due to the wide variety of genetic variations that can be found in tumour DNA and our incomplete understanding of their impact. Proper understanding and communication of test results are critical to patient care and to inform patients of their and their family’s future cancer risks.10
BRCA test results can inform prognosis and treatment options
How can genetic counselling be streamlined by the multidisciplinary team?
Genetic counselling with a trained professional is available for patients to discuss the risks and benefits of genetic testing, to determine whether testing is appropriate, and discuss possible effects on the patient and their family.11
Delays in test turnaround times and genetic counselling can be barriers to BRCA testing.2
An oncogenetic pathway may provide patients earlier access to counselling.12
An oncogenetic pathway aims to streamline testing
NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
References:
- Larsen MJ et al. Breast Cancer (Auckl). 2014; 8:145-155.
- Hoogerbrugge N and Jongmans MC. Eur J Hum Genet. 2016; 24: S19-S26.
- Pal T et al. Cancer Control. 2012; 19(4): 255-66.
- Wallace AJ. Eur J Hum Genet. 2016; 24: S10-S18.
- Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Genetic/Familial High-Risk Assessment: Breast, Ovarian and Pancreatic V2.2021. National Comprehensive Cancer Network, Inc. All rights reserved. [Accessed March 2021]. To view the most recent and complete version of the guideline go online to NCCN.org.
- Pellegrino B et al. ESMO Open. 2019; 4(2): e000480.
- Miller RE et al. Ann Oncol. 2020; 31(12): 1606-1622.
- Robson ME et al. J Clin Oncol. 2010; 28: 893-901.
- George A et al. Sci Rep. 2016; 6: 29506.
- Li MM et al. J Mol Diagn. 2017; 19: 4-23.
- Jacobs C et al. Eur J Hum Genet. 2019; 27(4): 511-524.
- George A et al. Sci Rep. 2016; 6: 29506.