Awareness and availability of routine germline BRCA1/2 (gBRCA1/2) mutation testing in patients with Advanced Breast Cancer (ABC) in the outpatient oncology setting in Germany

Introduction We investigated clinical practice, awareness, and availability of routine gBRCA1/2 testing in German outpatient oncology setting.

Material 23-item online survey.

Methods Completed by 50 office-based oncologists (medical/gynecologic), October 2019-February 2020.

Results Known family history (FH) of gBRCA1/2-related cancer(s) and hormone receptor status influences gBRCA1/2 testing (Table). Most oncologists routinely test ABC patients with triple-negative breast cancer (TNBC) independent of FH; only reason for not testing TNBC patients (n=3) was reimbursement difficulties. Testing rates for HR+/HER2- ABC patients were generally lower and depended on FH. Reasons for not testing HR+/HER2- ABC patients (n; with FH 7, without 33): available therapy alternatives [rate (%); with FH 100.0, without 54.5], reimbursement difficulties [rate (%); with FH 28.6, without 24.2] or other [rate (%); with FH 0, without 24.2]. Other factors included guideline recommendations and age at BC onset. Test turnaround time [median (range); 4.0 (1.0-21.0) weeks] and availability of genetic counseling influenced when oncologists routinely initiate gBRCA1/2 testing (46.0 %; 36.0 %, respectively). Most oncologists reported access to gBRCA1/2 testing as satisfactory (30.0 %) or good (36.0 %).

Conclusion gBRCA1/2 testing seems established in Germany’s outpatient oncology setting. Opportunities exist to improve testing of HR+ ABC patients without family history given gBRCA1/2-targeted therapy options. Funding: Pfizer.

Tab. 1 gBRCA1/2 testing rates [% (n/N)] in ABC patients by subtype and family history (n=number of physicians who replied yes; N=number of physicians asked)

ABC Subtype	ABC patients WITH known family history of gBRCA1/2-related cancer(s): Testing Rate in % (n/N)	ABC patients WITHOUT known family history of gBRCA1/2-related cancer(s): Testing Rate in % (n/N)
TNBC	98.0 (49/50)	92.0 (46/50)
HR+/HER2-	82.0 (41/50)	30.0 (15/50)
HR+/HER2+	76.0 (38/50)	10.0 (5/50)
HR-/HER2+	82.0 (41/50)	16.0 (8/50)

Publication History

Article published online:
24 June 2020