Effects of initiating physician-performed germline testing in safety net clinic patients with epithelial overian cancer.
Effects of initiating physician-performed germline testing in safety net clinic patients with epithelial overian cancer.
复制标题
DOI：
10.1016/j.gore.2020.100662
复制
发表时间：
2020-11
影响因子：
1.2
通讯作者：
Huang M
中科院分区：
文献类型：
--
作者：
Jordan SE;Spring S;Kamath P;Schlumbrecht MP;Matthew Pearson J;Sinno AK;George SHL;Huang M
快速生殖细胞检测是上皮性卵巢癌治疗的重要组成部分。没有保险和少数民族患者面临生殖细胞检测率较低的风险。医生进行的生殖系检测缩短了安全网诊所人群中报告结果的间隔。大多数接受测试的患者在测试时没有保险或保险不足。生殖系基因突变发生在大约25%的上皮性卵巢癌（EOC）女性中。我们试图确定与历史对照相比，新启动的肿瘤学家领导的办公室生殖细胞检测是否改善了检测时间和结果传播。确定了2018年4月1日至2019年12月31日期间观察到的上皮性卵巢癌患者。在妇科肿瘤诊所提供基因检测试剂盒之前接受治疗的患者与之后接受治疗的患者进行比较。使用卡方和Fisher精确检验比较分类变量。使用考克斯比例风险模型比较从测试到结果的经过时间。确定了73例患者，分析了502次门诊访视。56例（76.7%）患者为白色西班牙裔，15例（20.5%）为黑人，2例（2.7%）为白色非西班牙裔。55例（75.7%）进行了生殖细胞检测。干预组的中位基因检测时间短于对照组（5周vs 24.3周，95% CI = 0-10.8 vs 14.9-33.7，p < 0.001）。在完成基因检测的51例患者中，干预组在首次访视后14周（95%CI = 0-28.1）时将结果记录在临床记录中，而对照组为47周（95%CI = 30.7-63.3）（p < 0.001）。大多数接受测试的患者都有县慈善护理保险或没有保险。在安全网妇科肿瘤诊所进行基因检测是可行的。通过启动办公室内检测，检测和收到结果的时间大大缩短。这使得能够及时识别从PARP抑制剂维持治疗中获益最大的患者。
Expeditious germline testing is a vital component of epithelial ovarian cancer treatment. Uninsured and minority patients are at risk for lower germline testing rates. Physician performed germline testing shortens the interval to results reporting in a safety net clinic population. The majority of patients tested were uninsured or underinsured at the time of testing. Germline genetic mutations occur in approximately 25% of women with epithelial ovarian cancers (EOC). We sought to determine whether newly initiated in-office oncologist-led germline testing improved time to testing and dissemination of results compared with historical controls. Patients with epithelial ovarian cancer seen between 4/1/2018 and 12/31/2019 were identified. Patients treated before genetic testing kits were made available in the gynecologic oncology clinics were compared to those treated after. Categorical variables were compared using Chi Squared and Fisher’s Exact test. Cox proportional hazards model was used to compare elapsed time from testing to results. 73 patients were identified, and 502 clinic visits were analyzed. 56 (76.7%) patients were White Hispanic, 15 (20.5%) were Black, and 2 (2.7%) were White non-Hispanic. 55 (75.7%) underwent germline testing. Median time to genetic testing in the intervention group was shorter than in the control group (5, vs 24.3 weeks, 95% CI = 0–10.8 vs 14.9–33.7, p < 0.001). Among the 51 patients with genetic tests completed; results were recorded in a clinic note at 14 weeks (95% CI = 0–28.1) from first visit in the intervention group compared with 47 weeks (95% CI = 30.7–63.3) in the control group (p < 0.001). The majority of patients tested had county charity care insurance or were uninsured. Genetic testing in a safety net gynecologic oncology clinic is feasible. By initiating in-office testing, time to testing and receipt of results were meaningfully shortened. This allowed for timely identification of patients who would most benefit from PARP inhibitor maintenance therapy.
登录
查看更多内容
影响因子：
28.4
作者：
Norquist BM;Harrell MI;Brady MF;Walsh T;Lee MK;Gulsuner S;Bernards SS;Casadei S;Yi Q;Burger RA;Chan JK;Davidson SA;Mannel RS;DiSilvestro PA;Lankes HA;Ramirez NC;King MC;Swisher EM;Birrer MJ
通讯作者：
Birrer MJ
影响因子：
50.5
作者：
Paluch-Shimon, S.;Cardoso, F.;Senkus, E.
通讯作者：
Senkus, E.
影响因子：
4.7
作者：
Manrriquez, Erica;Chapman, Jocelyn S.;Chen, Lee-may
通讯作者：
Chen, Lee-may
影响因子：
158.5
作者：
Gonzalez-Martin, A.;Pothuri, B.;Monk, B. J.
通讯作者：
Monk, B. J.
影响因子：
45.3
作者：
Colombo, Nicoletta;Huang, Gloria;Blakeley, Christopher
通讯作者：
Blakeley, Christopher