Universal Testing May Help Bolster Long Term Ovarian Cancer Survivorship

In a conversation with CancerNetwork® Melissa K. Frey, MD, associate professor of Obstetrics and Gynecology in the Division of Gynecologic Oncology and director of Genetics and Personalized Cancer Prevention Program at Weill Cornell Medicine, highlighted how integrated genetic counseling and testing services have improved outcomes among patients with ovarian cancer. She began by suggesting that an awareness of a genetic mutation influences treatment will enable more appropriate, personalized treatment for these patients.

Frey then expressed that greater long-term survivorship of ovarian cancer has emerged in conjunction with greater use of genetic testing, which has led to an emerging benefit of genetic testing beyond ovarian cancer treatment: risk-stratification for other diseases. Particularly, she explained that patients with BRCA1 or BRCA2 mutations identified during genetic testing are at an elevated risk for breast cancer, and that enhanced breast cancer screening may be employed following their treatment for ovarian cancer.

She concluded by saying that genetic screening for a variety of other disease states, including skin cancers and pancreatic cancers, will see improvements as the field continues to evaluate the association between genetic mutations and treatment decision-making.

Transcript:

Knowledge of a genetic mutation impacts treatment, and so the better a clinic is either able to embed genetic services into their clinic to maximize genetic testing or participate in mainstreaming where the patient can access genetic testing, even without a genetics professional, will allow for more patients to get tested. Our goal, again, is universal testing. The goal is 100% of [patients with] ovarian cancer are offered genetic testing, so the closer we can get to that, the better we are going to be able to offer patients the appropriate, personalized treatment.

I would also argue that we are getting better at treating ovarian cancer, and as a result, which is a very positive thing, we have more long-term survivors. It's not only important to use genetic information to treat a tumor, but also to then consider a patient's health after their ovarian cancer treatment and to risk stratify patients for other diseases, most commonly breast cancer. Patients that are at increased risk of ovarian cancer because of a BRCA1 or BRCA2 mutation are also going to have significantly elevated lifetime risk for breast cancer. These are patients who, when they complete their ovarian cancer treatment, can also consider enhanced breast cancer screening.

I think we will get better at additional screening, for example, pancreatic cancer screening, skin cancer screening, and all things that we are learning more about and trying to better understand the association with genetic mutations.