Real-world genetic testing patterns in metastatic castration-resistant prostate cancer
Neal Shore1, Raluca Ionescu-Ittu2, Lingfeng Yang3
1Carolina Urologic Research Center, Myrtle Beach, SC 29572, USA.
Future Oncology (London, England)
|April 28, 2021
Summary
Genetic testing for homologous recombination repair mutations in metastatic castration-resistant prostate cancer (mCRPC) was underutilized before PARP inhibitor approval. Academic centers showed higher testing rates, indicating access disparities.
Area of Science:
- Oncology
- Genetics
- Medical Informatics
Background:
- Metastatic castration-resistant prostate cancer (mCRPC) is a complex disease.
- Homologous recombination repair (HRR) gene mutations are important therapeutic targets in mCRPC.
- PARP inhibitors represent a significant advancement in mCRPC treatment.
Purpose of the Study:
- To evaluate the utilization patterns of genetic testing for HRR mutations in mCRPC patients.
- To identify predictors of genetic testing uptake before the approval of PARP inhibitors.
- To assess the accessibility of genetic testing in different healthcare settings.
Main Methods:
- Retrospective analysis of mCRPC patients from an oncology electronic medical records database.
- Assessment of testing rates for specific HRR genes (ATM, BRCA1/2, CDK12, PALB2, FANCA).
- Statistical analysis to determine predictors of genetic testing, including healthcare setting.
Main Results:
- Only 13% (674 of 5213) of mCRPC patients underwent documented genetic testing.
- A significant increase in testing was observed from 2013 to 2018.
- Care at an academic oncology center was a strong predictor of genetic testing (HR=2.41).
Conclusions:
- Genetic testing for HRR mutations in mCRPC patients was suboptimal prior to PARP inhibitor approval.
- Disparities in access to genetic testing exist, favoring academic centers.
- Improved strategies are needed to enhance genetic testing uptake in mCRPC.
