Barriers and Breakthroughs in Precision Oncology: A National Registry Study of BRCA Testing and PARP Inhibitor Uptake in Women from the National Gynae-Oncology Registry (NGOR)
Australia is a wealthy nation with universal health care. Despite this some women with ovarian cancer do not receive best care. This prospective study using the National Gynae-Oncology Registry (NGOR), looks at the extent of genetic testing of the BRCA variant and the subsequent chance of PARP inhibitor (PARPi) therapy.
Survival for women with ovarian cancer has been significantly improved with the introduction of PARPi. This treatment of defective DNA repair is recommended for the approximately 50% of women, who demonstrate this on genetic or biomarker testing. Data from the NGOR show a disparity in testing, with older women and women from regional communities being less likely to be tested.
About 70% of women with ovarian cancer in Australia have genetic testing, which is good by international standards. However, for women aged 80 or more the likelihood of them having genetic testing is reduced to half that of younger patients. Living in a non-metropolitan location (about 1/3rd of the group) reduced the testing rate also, to about 60%.
Of women likely to benefit from PARPi, about half start therapy. This outcome is similar in other countries such as the US. Why this is so is unclear, other factors may be important, with women of higher socio-economic status being more likely to progress to PARPi. The authors suggest the findings indicate a need for better management of ovarian cancer.
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