Evaluation of a Mainstream Model of Genetic Testing for Men With Prostate Cancer

PURPOSE: To identify the approximately 12% with inherited cancer predisposition, all men metastatic prostate (mPC) should be offered germline genetic testing. This guides treatment choices and impacts prevention in family. Limited services globally present a barrier to study tested potential solution, “mainstreaming,” where counseling testing are performed by patient’s oncologist. PATIENTS AND METHODS: Men mPC at three Australian sites were their medical oncology appointment. Panel ( ATM, BRCA1, BRCA2, BRIP1, CHEK2, EPCAM, FANCA, HOXB13, MLH1, MSH2, MSH6, NBN, PALB2, PMS2, RAD51D, TP53) was on saliva/blood (Invitae, San Francisco, CA). Primary outcomes clinician patient satisfaction. Secondary included mutation rates resource allocation. RESULTS: Of 66 testing, 63 (95%) accepted. Four pathogenic variants identified (two one MSH6). Fifty patients nine clinicians completed questionnaires. Satisfaction high. All pleased have had overall, 98% (46 of 47) usual appointment, receive results from specialist, rather than separate genetics A total 88% (7 8) felt confident, satisfied mainstreaming. Mainstreaming efficient, requiring 87% fewer consultations traditional counseling. CONCLUSION: demonstrates that mainstreaming is feasible, satisfactory for patients. Widespread implementation as standard care would facilitate timely access mPC.