Analiza obravnav na Oddelku za onkološko klinično genetiko po posamezni lokaciji raka in pomen genetskih izvidov pri načrtovanju zdravljenja
Analysis of assessments at the Department of Clinical Cancer Genetics by cancer site and the importance of genetic findings in treatment planning

Authors

  • Nina Zavrl Onkološki inštitut Ljubljana
  • Simona Hotujec Onkološki inštitut Ljubljana
  • Srdjan Novaković Onkološki inštitut Ljubljana
  • Stegel Vida Onkološki inštitut Ljubljana
  • Mateja Krajc Onkološki inštitut Ljubljana

DOI:

https://doi.org/10.25670/oi2024-012on

Keywords:

PARP inhibitors, breast cancer, ovarian cancer, prostate cancer, pancreatic cancer, family history, BRCA1/2, genetic testing, pathogenic variant

Abstract

Izhodišče: Na Onkološkem inštitutu Ljubljana (OIL) obravnavamo bolnike z rakom, pri katerih je izvid genetskega testiranja pomemben za načrtovanje zdravljenja in če obstaja velika verjetnost, da je pri njih prisoten dedni sindrom za raka. Namen raziskave je bil analizirati trend obravnav pri bolnikih z rakom in oceniti stopnjo odkrivanja nosilcev zarodnih genetskih okvar. Prav tako smo analizirali stopnjo odkrivanja zarodnih patogenih različic/verjetno patogenih različic (PR/VPR) glede na družinsko anamnezo. Metode: S pomočjo programa MS Excel in deskriptivnih statističnih metod smo na Oddelku za onkološko klinično genetiko, OIL, analizirali podatke o številu napotitev, družinski anamnezi in genetskih rezultatih po štirih lokacijah raka (dojk, jajčnikov, prostate in trebušne slinavke) za obdobje od 1. 1. 2020 do 30. 6. 2024. Rezultati: V 4,5 leta je bilo na genetsko svetovanje poslanih 4.252 bolnikov, največ z rakom dojk (3.074). V povprečju je od diagnoze do testiranja za zarodne PR/VPR minilo 4,3 leta. Med vsemi testiranimi smo pri 16,5 % odkrili zarodno PR/VPR. Največja stopnja odkrivanja zarodnih PR/VPR je bila pri testiranih bolnicah z rakom jajčnikov (25,2 %), sledijo bolniki z rakom trebušne slinavke (16,2 %) in dojk (16,2 %) ter bolniki z rakom prostate (11,1 %). Najpogosteje so bile najdene zarodne PR/VPR v genih BRCA1/2. Delež bolnikov s pozitivnim genetskim izvidom med vsemi, ki so imeli pozitivno družinsko anamnezo je bil 19,5 %, med bolniki z negativno družinsko anamnezo pa 12,4 %. Zaključek: Analiza potrjuje pomen genetskega testiranja zarodnih PR/VPR pri bolnikih z rakom. Pri 16,5 % bolnikov je bil rezultat testiranja lahko uporabljen za načrtovanje zdravljenja in preventive za njihove svojce. Menimo, da bi bilo smiselno razmisliti o uvedbi univerzalnega genetskega testiranja za bolnike z določenimi diagnozami raka in kaskadnega testiranja svojcev v varnem kliničnem okolju.


Abstract (Eng)

Introduction: The Institute of Oncology Ljubljana (IOL) provides genetic assessment for cancer patients who require test results for treatment planning and whenever there is a risk of a hereditary cancer syndrome. In this study, we aimed to analyse the trend of referrals of cancer patients and to assess the pathogenic / likely pathogenic variant (PV/LPV) detection rate in tested individuals according to family history. Methods: In the Department of Clinical Cancer Genetics, IOL, we performed data analysis using descriptive statistical methods and the Microsoft Excel tool. It was based on the number of referrals, patients’ family history data and their genetic test results for germline PV/LPV, focusing on specific cancer site (breast, ovaries, pancreas, and prostate) between 01/01/2020 and 30/06/2024. Results: In a period of 4.5 years, 4,252 patients were referred for genetic counselling, in particular breast cancer patients (3,074). On average, it took 4.3 years from cancer diagnosis to germline genetic testing. 16.5% of all patients tested were diagnosed with germline PV/LPV. Germline PV/LPV were mostly found in ovarian cancer patients (25.2%), followed by pancreatic cancer patients (16.2%), breast cancer patients (16.2%), and prostate cancer patients (11.1%). PV/LPV were most frequent in the genes BRCA1/2. The percentage of patients with a positive family history who tested positive was 19.5%, whereas the percentage of patients with a negative family history was 12.4%. Conclusion: The survey proves the importance of germline genetic testing for cancer patients and their relatives. In fact, 16.5% of patients tested positive for germline PV/LPV and the results were used for treatment planning and prevention. Therefore, it would be reasonable to consider introducing universal genetic testing for certain cancer patients in a safe clinical setting and to be able to identify all those at higher cancer risk.

Published

2024-12-20

How to Cite

Zavrl, N., Hotujec, S., Novaković, S., Vida, S., & Krajc, M. (2024). Analysis of assessments at the Department of Clinical Cancer Genetics by cancer site and the importance of genetic findings in treatment planning. Onkologija : Slovenian Journal of Oncology, 28(2), 6–14. https://doi.org/10.25670/oi2024-012on

Issue

Section

Original Scientific Article