With technology these days, if you have a patient who has a daughter who is 21 tested positive, obviously, we are going to make interventions at that point for her. we can identify patients who have germline mutations that place their family members at a higher risk for ovarian cancer, then we can intervene in those patients with risk-reducing surgery. However, also, an ounce of prevention is better than a pound of cure. That is important because that will help us to determine who may qualify for medications after chemotherapy. First, think about a good surgery, chemotherapy for the majority of patients, and then the germline genetic testing component. We do not want to have everyone focused on tumor testing. Krivak: For patients with advanced ovarian cancer, you have to always think about germline testing. OncLive®: What are some of your key treatment considerations for patients with ovarian cancer? In an interview with Oncology Nursing News' sister publication, OncLive® during an Institutional Perspectives in Cancer webinar on Ovarian Cancer, Krivak, director of the Ovarian Cancer Center for Excellence and co-chair of the Society of Gynecologic Oncology Research Institute at Allegheny Health Network, discussed the significance of HRD in ovarian cancer, approved and prospective HRD tests, and considerations for genomic testing in this population. “I would have to say HRD is this concept that each company is going to define, and then it is going to be up to the individual clinician, whether that is a pathologist or someone who specializes in genetics and cancer, who will say, ‘We think this is the best test for these reasons and this is what we are going to do in our practice.' I do not think there is a perfect test out there.” “I do not believe there is going to be standardization,” Krivak said. 4 Because approved and prospective HRD tests have different definitions, standardization may not be possible, according to Krivak. 3 In comparison, FoundationOne CDx defines HRD as patients with tumor tissue BRCA positivity and/or a high loss of heterozygosity. FoundationOne CDx identifies HRD based on deleterious or suspected deleterious mutations in BRCA1/2 and/or a positive Genomic Instability Score. Importantly, both tests define HRD in differently. 1,2 Although both tests are useful, the clinical data to support m圜hoice CDx may be more compelling, according to Krivak.
#Tempus hrd plus
The m圜hoice CDx, developed by Myriad Genetics, was approved by the FDA in May 2020 as a companion diagnostic for olaparib (Lynparza) plus bevacizumab (Avastin) in patients with advanced ovarian cancer, while the FoundationOne CDx, developed by Foundation Medicine, was approved in November 2017to identify molecular abnormalities in several solid tumors, including ovarian cancer. However, differences between these assays can make standardization of their use difficult. Two tests for homologous recombination deficiency (HRD) have been FDA approved for patients with ovarian cancer, including m圜hoice CDx and FoundationOne CDx, and they produce important information that can be used to guide treatment decisions, according to Thomas C.
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