Abstract P1-03-03: Experience in the community oncology practice with a 25-gene hereditary cancer panel

Introduction: The identification of patients with an inherited cancer syndrome is becoming increasingly relevant in the treatment and prevention of cancer. Testing with a panel of genes provides the opportunity to rapidly identify or rule out deleterious mutations in several genes simultaneously and, thus, has the potential to streamline the testing process and more efficiently and accurately provide results. We report on the experience of panel-based testing in the community oncology setting. Objectives: To evaluate the performance of a 25-gene hereditary cancer test in the community oncology setting and describe the patient characteristics and test findings. Methods: We retrospectively evaluated the 25-gene panel testing data obtained between September 2013 and February 2014 in 6 large community oncology practices. The gene panel was based on next generation sequencing and rearrangement analysis of 25 genes with cancer risk data: BRCA1, BRCA2, MLH1, MSH2, MSH6, PMS2, EPCAM, APC, MUTYH, CDKN2A, CDK4, PALB2, CHEK2, SMAD4, BMPR1A, STK11, TP53, CDH1, PTEN, ATM, NBN, BARD1, BRIP1, RAD51C, and RAD51D. Personal and family history was obtained by health care provider report on test requisition forms. Results: The panel test was performed on 359 individuals during the time period. 69.9% of these patients had a phx of at least one of the eight panel cancers: breast, ovarian, colorectal, endometrium, pancreas, melanoma, prostate, and/or stomach. cancer diagnosis. 97.8% of the patients tested met the 2013 NCCN guideline criteria for HBOC, 2012 NCCN guideline criteria for Lynch Syndrome, or both. 37 pathogenic mutations were found in 34 distinct patients. The variant rate in this population was 35.4%. Mutations were identified in 16 different genes, and only 20 of the 37 mutations (54.1%) were found to be in the 6 genes included in HBOC and Lynch Syndrome testing (BRCA1, BRCA2, MSH6, MLH1, MSH2, PMS2). Conclusion: The 25-gene hereditary cancer panel increased the identification of deleterious mutations which would otherwise not have been detected. The variant rate in this setting is similar to the rate reported previously in both community and academic centers where panel testing is used. Use of a hereditary cancer panel in the community oncology practice may improve detection rates and provide an opportunity for enhanced cancer management. Citation Format: Sami Diab, Patricia Rodriguez, Anna Leininger, Lisa Clark, Mike F Janicek, Ellen B Smith, John Sandbach, Jennifer Saam, Lucy Langer. Experience in the community oncology practice with a 25-gene hereditary cancer panel [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P1-03-03.