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PURPOSE Tubo-ovarian cancer (TOC) is a sentinel cancer for BRCA1 and BRCA2 pathogenic variants (PVs). Identification of a PV in the first member of a family at increased genetic risk (the proband) provides opportunities for cancer prevention in other at-risk family members. Although Australian testing rates are now high, PVs in patients with TOC whose diagnosis predated revised testing guidelines might have been missed. We assessed the feasibility of detecting PVs in this population to enable genetic risk reduction in relatives. PATIENTS AND METHODS In this pilot study, deceased probands were ascertained from research cohort studies, identification by a relative, and gynecologic oncology clinics. DNA was extracted from archival tissue or stored blood for panel sequencing of 10 risk-associated genes. Testing of deceased probands ascertained through clinic records was performed with a consent waiver. RESULTS We identified 85 PVs in 84 of 787 (11%) probands. Familial contacts of 39 of 60 (65%) deceased probands with an identified recipient (60 of 84; 71%) have received a written notification of results, with follow-up verbal contact made in 85% (33 of 39). A minority of families (n = 4) were already aware of the PV. For many (29 of 33; 88%), the genetic result provided new information and referral to a genetic service was accepted in most cases (66%; 19 of 29). Those who declined referral (4 of 29) were all male next of kin whose family member had died more than 10 years before. CONCLUSION We overcame ethical and logistic challenges to demonstrate that retrospective genetic testing to identify PVs in previously untested deceased probands with TOC is feasible. Understanding reasons for a family member's decision to accept or decline a referral will be important for guiding future TRACEBACK projects.

5568Background: To determine if chemotherapy dose reductions and delays in the adjuvant setting impact ovarian cancer pt outcomes. Secondary objective is comparing deliverability of three weekly an...

10062Background: Patients with OC are followed clinically every 3 months (m) after 1LT with the aim of managing symptoms/late AEs and diagnosing recurrence. Studies report that clinicians are unawa...

10081Background: Women with ovarian cancer (OC) report high rates of anxiety (A) and depression (D), but most studies have used a cross-sectional design at a single time-point, not considered prior...

155 Background: Women with ovarian cancer (OC) report high rates of anxiety (A) and depression (D), but most studies have used a cross-sectional design at a single time-point, not considered prior history and not included affected women who are symptom-free due to medication. Our goals were to quantify (i) the total burden of A and D among women with newly diagnosed OC; the proportions who (ii) experience symptoms only after their OC diagnosis and (iii) with persistent symptoms; and (iv) use of appropriate medication/services by those affected. Methods: The OPAL (Ovarian Cancer Prognosis & Lifestyle) Study is a prospective study of Australian women diagnosed with OC from 2012-15 who agreed to complete questionnaires at baseline, 3, 6, 9, 12, 24, 36 & 48 months after diagnosis. At baseline, they were asked if they had ever been diagnosed with A or D and if they took medication for this in the year before their OC diagnosis. At follow-up they completed the Hospital Anxiety and Depression Scale (HADS) and were asked about current medication use. Results: Of 893 women with data for ≥1 time point, 216 (24%) reported clinical levels (HADS > 10) of anxiety (18%) and/or depression (15%) on at least one occasion during the first 3 years after diagnosis, with another 157 (18%) reporting use of anxiolytic or antidepressant medications. A further 167 (19%) reported subclinical (HADS 8-10) A or D. Of those with clinical levels of A/D and/or taking medication, 225 (60%) reported this at ≥3 time-points, 216 (58%) reported no prior history of A or D, and 271 (73%) reported no use of anxiolytic/antidepressant medication in the year before diagnosis. When women reported clinical levels of A or D, only 45% reported taking medication (37%) and/or seeing a psychiatrist or psychologist (19%). Conclusions: More than 40% of women with OC experienced clinical levels of A or D during treatment or the first 3 years of follow-up, for 25% this persisted. For 24% this was their first experience of distress and > 50% of those affected did not receive appropriate medication or psychological support. The hidden burden of anxiety and depression in this population is much greater than previously reported but is amenable to effective intervention if recognized.

88 Background: Five-year survival after a diagnosis of ovarian cancer (OC) is < 45% and women often ask what they can do, beyond following the recommended treatment, to improve their chance of survival. The OPAL Study addresses the question of whether lifestyle choices during or after treatment could positively impact quality of life (QoL) and, ultimately, survival. Methods: OPAL is a prospective study of Australian women newly diagnosed with primary OC from 2012-15 who agreed to complete questionnaires at baseline, 3, 6, 9, 12, 24, 36 & 48 months after diagnosis. Baseline data include sociodemographic, reproductive & hormonal, medical & family history, and lifestyle (diet, alcohol, smoking, physical activity, sitting time) information. At follow-up, women are asked about their current lifestyle, medication and complementary therapy use, and a range of patient-reported outcomes including the Hospital Anxiety and Depression Scale, Insomnia Severity Index and FACT instruments for ovarian cancer, neurotoxicity and fatigue. 85% also provided a blood sample at recruitment and/or 12 months after diagnosis. Detailed treatment and outcome data are collected annually from medical records. Results: Of 1451 eligible women identified, 219 were excluded and 274 declined leaving a cohort of 958; 72% have high-grade serous and 72% advanced stage disease. Follow-up is now close to 36 months with questionnaire response rates of 85-95% among active participants. At October 2017, we had received 734, 751, 636, 434 and 225 questionnaires at 6, 12, 24, 36 and 48 months, respectively; women have completed a mean of 5 questionnaires (range 1-8). A total of 558 (58%) have experienced disease progression or recurrence, 332 (35%) have died and 300 are still active in the study. The proportion of women reporting clinical levels of anxiety ranges from 6-9% at each time-point, depression from 5-7%, insomnia from 9-14% and fatigue from 30-57%. Conclusions: This is the first prospective study to collect detailed lifestyle, QoL, clinical and outcome information from a large population-based cohort of women newly diagnosed with OC. It provides a valuable resource to identify relationships between potentially modifiable aspects of lifestyle and outcomes (QoL & survival) in women with OC.

172 Background: Patients often ask if/when they will feel normal again following treatment for ovarian cancer (OC). There is a paucity of data on the trajectories of quality of life (QoL), physical (PWB), social (SWB), emotional (EWB) and functional (FWB) wellbeing over time following chemotherapy and especially regarding those who have persistent problems. Our aim was to quantify the proportion of women with significantly lower QoL/wellbeing than the general population at the end of treatment and determine if/when they return to normal. Methods: The OPAL (Ovarian cancer Prognosis & Lifestyle) Study is a prospective study of Australian women diagnosed with invasive OC from 2012-15 who agreed to complete regular questionnaires after diagnosis. 580 participants who received ≥3 cycles of platinum-based chemotherapy as primary treatment and completed a questionnaire while on or < 6 weeks after completing chemotherapy (baseline) were included. FACT-G data came from questionnaires at baseline and ~3, 6, 9 & 18 months post-baseline. Group-based trajectory models were used to identify groups with distinct patterns of QoL/wellbeing over time. Results: Overall, 44% (254) of women had QoL scores significantly lower than the general population at baseline; 35% (88) returned to normal by 3 months after treatment, 73% by 6 months and 27% (69) had not returned to normal by 18 months. The Table shows the comparable figures for the wellbeing subscales. Conclusions: While > 50% of women with OC can expect similar QoL, FWB and EWB to the general population at the end of chemotherapy, PWB was compromised in 3 of 4 women. For most, wellbeing recovered within 6 months but a substantial proportion reported ongoing deficits. A particularly prolonged impact was seen for those with poor EWB at baseline, warranting early intervention in this subset. [Table: see text]

1521 Background: Women with an inherited mutation in a mismatch repair (MMR) gene have a substantially increased risk of endometrial cancer (EC) during their lifetime. In the general population, ri...

5026 Background: It has been accepted that 5-10% of all invasive epithelial ovarian cancer cases can be attributed to hereditary pathogenic mutations in cancer predisposition genes. Consequently ge...