Factors Affecting Quality Control (QC) Failure Rates in Somatic Breast Cancer (BRCA) Gene Testing in Castrate Resistant Prostate Cancer: Experiences From an Australian Cancer Care Centre.
Cian O'Leary, Edward Yoong, Admire Matsika, Niara Oliveira
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Abstract
Aims: Castrate-resistant prostate cancer (CRPC) is a common malignancy with poor prognostic outcomes. Breast cancer (BRCA) genes 1 and 2 mutations occur in prostate cancers and confer poorer prognoses. Somatic BRCA testing can lead to inconclusive results, which can gatekeep patients from accessing targeted medications. We assessed the somatic BRCA testing results among our cohort of CRPC patients for factors contributing to quality control (QC) failures and inconclusive testing.
Methods: We performed a retrospective review of the records of all patients with CRPC attending our cancer care centers from 2020 to 2023. We identified the presence/absence of somatic BRCA testing results on their record. For those with returned results, we collected key information including biopsy characteristics, time from biopsy to BRCA result, and outcome of BRCA testing.
Results: A total of 147 patients with CRPC attended our service between January 2020 and 2023. A total of 54 patients (40%) had somatic BRCA testing performed on a tumor biopsy sample. A total of 35 somatic tests (65%) returned an actionable (positive or negative) result. The remaining 19 (35%) returned as inconclusive/QC failures. QC failures were significantly associated with a greater time from initial biopsy to somatic testing result (60 vs. 27 months, p = 0.033). The type of tissue biopsied, tumor percentage in biopsy sample, tissue sampling method, and sampling hospital did not contribute significantly to QC failure.
Conclusions: A longer tissue retention interval from biopsy to somatic BRCA testing is associated with a greater risk of inconclusive test results. We recommend a repeat biopsy for BRCA testing in CRPC patients where archival tissue is older than 5 years.
期刊介绍：
Asia–Pacific Journal of Clinical Oncology is a multidisciplinary journal of oncology that aims to be a forum for facilitating collaboration and exchanging information on what is happening in different countries of the Asia–Pacific region in relation to cancer treatment and care. The Journal is ideally positioned to receive publications that deal with diversity in cancer behavior, management and outcome related to ethnic, cultural, economic and other differences between populations. In addition to original articles, the Journal publishes reviews, editorials, letters to the Editor and short communications. Case reports are generally not considered for publication, only exceptional papers in which Editors find extraordinary oncological value may be considered for review. The Journal encourages clinical studies, particularly prospectively designed clinical trials.
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