For a study, researchers sought to provide a detailed analysis of the testing frequency, patient characteristics, temporal trends, timing, and outcomes of somatic and germline BRCA testing in ovarian cancer patients using actual data.
They included a cross-sectional subgroup of adult ovarian cancer patients who underwent frontline therapy and were monitored for at least a year in a real-world database between January 1, 2011, and November 30, 2018. Receiving a BRCA test, which was defined as germline (blood or saliva) or somatic (by the source of the biosample), was the main result (tissue). Based on the dates of surgery and chemotherapy, the lines of therapy (frontline, second line, third line) were developed. Analysis of descriptive statistics was done.
There were 2,557 patients, and 1,846 (72.2%) had at least one verified BRCA test. About 10.6% (n=197) of the studied individuals had just somatic testing, 19.9% (n=368) had both somatic, and germline testing, and 62.5% (n=1,154) had only germline testing. Most patients underwent testing before (9.7%, n=276) or during (48.6%, n=1,521) frontline therapy. 17.6% (n=273) and 12.7% (n=129) of patients had testing during second-line and third-line therapy, respectively. There were differences by Eastern Cooperative Oncology Group performance score (P<.001), stage of disease (P<.001), histology (P<.001), geography (P<.001), and type of frontline therapy (P<.001), but no differences based on race or ethnicity. Patients who underwent BRCA testing were younger (mean age 63 years vs. 66 years, P<.001) and more likely to receive care at an academic practice (10.4% vs. 7.0%, From 24.6% of patients in 2011 to 75.6% of patients in 2018, more patients had BRCA testing within a year of their diagnosis.
Testing for actionable BRCA mutations showed considerable practice discrepancies in a sizable group of ovarian cancer patients. Despite a rise in testing over time, many individuals did not undergo testing, indicating missed chances to identify patients who would benefit from targeted medication and genetic counseling.