(UroToday.com) Prostate cancer is the most common non-cutaneous cancer diagnosed in men. All men with metastatic prostate cancer, as well as selected other patients with specific family histories, are recommended to undergo germline genetic testing. Given global limitations on genetic counseling services, this study designed an intervention to have medical oncologists perform pre-genetic testing counseling, arrange genetic testing, and provide initial results. The primary outcome of the intervention was clinician and patient satisfaction, with secondary outcomes of resource allocation and patient uptake of genetic counseling.
For this study, medical oncologists were recruited at 3 Australian sites in Victoria and New South Wale. Providers received face-to-face training regarding how to counsel patients and conduct testing. Testing was done with the Invitae germline panel. Patients with results identifying a pathogenic variant, a variant of unknown significance, or no results but significant family history were referred to a genetics counselor. In total, 66 patients were offered genetic testing, 63 of whom underwent testing. Of these, 61 patients received results, and 50 patients returned surveys from the study. The results are summarized below:
Of the 63 patients who underwent genetic testing with their oncologist, only 16 had results or clinical scenarios that required subsequent referral to a genetic counselor, and these patients only needed 1 visit with that counselor. Typically, patients require a pre-testing and a results review consultation, or two consultations in total with a counselor. Extrapolating this to the ~6000 men diagnosed with metastatic prostate cancer annually, the authors estimate that main-streaming genetic counseling through medical oncology would require 87% fewer genetic counselor consultation.s
Presented by: Tahlia Scheinberg, MBBS, Clinical Prostate Cancer Group, Garvan Institute of Medical Research and University of Sydney, Sydney, Australia
Written by: Alok Tewari, MD, PhD, Medical Oncology Fellow at the Dana-Farber Cancer Institute, at the 2020 ASCO Annual Meeting, Virtual Scientific Program #ASCO20, May 29-31, 2020.