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    Seminars in oncology. 2017 Sep 15. pii: S0093-7754(17)30052-0. doi: 10.1053/j.seminoncol.2017.08.004
    Guidance Statement On BRCA1/2 Tumor Testing in Ovarian Cancer Patients.
    Capoluongo E1,  Ellison G2,  López-Guerrero JA3,  Penault-Llorca F4,  Ligtenberg MJL5,  Banerjee S6,  Singer C7,  Friedman E8,  Markiefka B9,  Schirmacher P10,  Büttner R11,  van Asperen CJ12,  Ray-Coquard I13,  Endris V14,  Kamel-Reid S15,  Percival N16,  Bryce J17,  Röthlisberger B18,  Soong R19,  de Castro DG20
    Author information
    1Catholic University of the Sacred Heart and A. Gemelli Teaching Hospital Foundation, Rome, Italy.
    2AstraZeneca, Alderley Park, Macclesfield, UK.
    3Fundación Instituto Valenciano de Oncología, València, Spain.
    4Departement de Pathologie, Centre Jean Perrin; INSERM UMR 1240, Clermont-Ferrand, France.
    5Radboud University Medical Center, Nijmegen, Netherlands.
    6The Royal Marsden NHS Foundation Trust, London, UK.
    7Medical University of Vienna, Vienna, Austria.
    8Sheba Medical Center, Tel Hashomer, Israel.
    9University of Cologne, Cologne, Germany.
    10University Hospital Heidelberg, Germany.
    11University of Cologne, Cologne, Germany.
    12Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands.
    13Claude Bernard University, Lyon, France.
    14University Hospital Heidelberg, Germany.
    15Princess Margaret Cancer Centre, Toronto, Canada.
    16The Royal Marsden NHS Foundation Trust, London, UK.
    17Nazionale Tumori IRCCS Pascale, Naples, Italy.
    18Kantonsspital Aarau, Aarau, Switzerland.
    19University of Singapore, Singapore.
    20Queen's University Belfast, Belfast, UK. Electronic address: D.GonzalezdeCastro@qub.ac.uk.
    Abstract

    The approval, in 2015, of the first poly (adenosine diphosphate-ribose) polymerase inhibitor (PARPi; olaparib, Lynparza) for platinum-sensitive relapsed high-grade ovarian cancer with either germline or somatic BRCA1/2 deleterious mutations is changing the way that BRCA1/2 testing services are offered to patients with ovarian cancer. Ovarian cancer patients are now being referred for BRCA1/2 genetic testing for treatment decisions, in addition to familial risk estimation, and irrespective of a family history of breast or ovarian cancer. Furthermore, testing of tumor samples to identify the estimated 3%-9% of patients with somatic BRCA1/2 mutations who, in addition to germline carriers, could benefit from PARPi therapy is also now being considered. This new testing paradigm poses some challenges, in particular the technical and analytical difficulties of analyzing chemically challenged DNA derived from formalin-fixed, paraffin-embedded specimens. The current manuscript reviews some of these challenges and technical recommendations to consider when undertaking BRCA1/2 testing in tumor tissue samples to detect both germline and somatic BRCA1/2 mutations. Also provided are considerations for incorporating genetic analysis of ovarian tumor samples into the patient pathway and ethical requirements.


    Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

    KEYWORDS: BRCA1, BRCA2, Ovarian cancer, Tumor testing

    Publikations ID: 29248130
    Quelle: öffnen
     
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