News — December 14, 2022 – Some prostate cancer patients have genetic mutations that may affect their treatment. A comprehensive on-site genetic testing program, developed by urologists, could help fill the gap for this underutilized resource, a study reports. Urology practice®an official journal of the American Urological Association (AUA). The journal is published in the Lippincott Portfolio by Wolters Kluwer.
Dr. Howard Korman, CEO and President of Comprehensive Urology, Royal Oak, Michigan, along with Chief Pathologist Dr. Kirk Wojno, pioneered and implemented a novel algorithm to deliver genetic testing to cancer patients newly diagnosed prostate, based on current guidelines. “This pathway has provided a uniform pathway for our 34 urologists across 20 different sites to meet the new standard of care for genetic testing, to improve patient compliance, and to improve the overall quality of patient care,” said Dr. Korman.
Simplified approach to detect mutations in prostate cancer
To further enhance the delivery of state-of-the-art cancer care, Dr. Korman’s team collaborated with a multidisciplinary team of medical oncologists. “Adopting a guideline-based model with on-site genetic testing has improved urologists’ ability to detect germline mutations,” notes oncologist Dr. Savitha Balaraman. “The urology group’s foresight to partner with medical oncologists has allowed us to better utilize targeted therapies, offer clinical trial enrollment and recommend cascade testing for family members, which which has greatly expanded the scope of patient and family care.
Research has identified several clinically important genetic mutations associated with prostate cancer, including mutations associated with more aggressive malignancy and poorer clinical outcomes. “Given the link between family history, genetic mutations and prostate cancer, the importance of genetic testing in the diagnosis and treatment of prostate cancer cannot be overstated,” says Dr. Korman.
Yet genetic testing for patients with prostate cancer remains “significantly underutilized”. A key factor is the lack of an effective protocol for notifying physicians when genetic testing and counseling may be indicated. Initially, genetic testing was done at the discretion of the treating urologist at the study clinic and required patients to make another visit to a separate facility.
Genetic testing protocol triples patient compliance rate
In 2018, the researchers introduced the full genetic testing protocol to their large urology practice. Following National Comprehensive Cancer Network guidelines, patients were referred for testing to identify mutations associated with prostate cancer based on family history of prostate cancer, hereditary breast cancer, or ovarian cancer. and Ashkenazi Jewish ancestry, among other factors. Testing was done during routine clinic visits, with follow-up genetic counseling provided by the patient’s urologist or other clinicians.
Although the clinic’s annual patient volume has remained roughly the same, the new workflow has significantly increased the number of patients undergoing genetic testing. The test was recommended for 474 patients after the guideline-based protocol was introduced, compared to 78 patients before the practice change.
The new protocol has approximately tripled patient adherence to recommended genetic testing: from 33.3% to 98.7%. Point-of-care testing has also reduced the time it takes to get genetic test results from 38 to 21 days.
“Given the growing importance of genetic testing in the management of prostate cancer, these results present a solution to strengthen the implementation of genetic testing in urology practices,” comments Dr. Korman. The authors plan another report detailing the types of mutations detected by the new testing workflow. The researchers highlight the need for larger studies to confirm their findings and discuss barriers to more widespread use of genetic testing for prostate cancer, including concerns about cost and insurance coverage.
Lily [Positive Impact of Implementing a Comprehensive Genetic Testing Protocol for Prostate Cancer Patients in a Multi-disciplinary Uro-oncology Practice]
About Urology practice
An official journal of the American Urological Association (AUA), Urology practice focuses on clinical trends, challenges and practical applications in the four areas of business, health policy, specialty and patient care. Information that can be used in daily practice will be provided to the urological community via peer-reviewed clinical practice articles (including best practices, reviews, clinical guidelines, selected clinical trials, editorials and white papers ), “research letters” (short original studies with an important clinical message), the affairs of urology practice, health policy issues in urology, education and training in urology, and the content for members of the urology care team.
About the American Urological Association
Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is one of the leading advocates for the specialty of urology and has more than 23,000 members worldwide. The AAU is a leading urological association, providing invaluable support to the urological community in pursuit of its mission to foster the highest standards of urological care through education, research and formulation of health care policy. health. To learn more about the AAU, visit: www.auanet.org
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