Daniel Josué Guerra Ordaz, Sera Whitelaw, Mohammed Kaouache, Amina Moustaqim-Barrette, Louise Gresham, Brandon Ramchatesingh, Margaret Redpath, May Chergui, Ivan V Litvinov
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Data on demographics, cancer type, stage, test ordering specialist, testing method, and treatment outcomes were extracted. Statistical analyses included descriptive and multivariate regression analyses.</p><p><strong>Results: </strong>518 BRAF molecular tests were performed, with 173 patients meeting the inclusion criteria [median age 72 (IQR 60-80 years), 46.2% female]. Of these, 75.7% had melanoma, 23.7% colorectal cancer and 0.58% lung cancer. Pathologists ordered 71.1% of BRAF tests, primarily relying on immunohistochemistry. By 2022, all BRAF results were available before oncology consultations. Patients with pre-consultation BRAF results were more likely to receive targeted therapy (59.4% vs 36.4%). The availability of BRAF test results was associated with quicker treatment initiation and better alignment of therapy with mutation status.</p><p><strong>Conclusion: </strong>This study underscores the success of the pathology team at MUHC in implementing reflex <i>BRAF</i> mutation testing, enhancing clinical care by ensuring the timely availability of test results. Delays in testing may adversely affect clinical decision-making and therapy selection, highlighting the need for standardized reflex testing protocols across Canada to optimize patient outcomes in melanoma, lung, and colorectal cancers.</p>","PeriodicalId":15403,"journal":{"name":"Journal of Cutaneous Medicine and Surgery","volume":" ","pages":"150-155"},"PeriodicalIF":3.1000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating the Implementation and Impact of BRAF Reflex Mutation Testing in Melanoma, Lung, and Colorectal Cancers.\",\"authors\":\"Daniel Josué Guerra Ordaz, Sera Whitelaw, Mohammed Kaouache, Amina Moustaqim-Barrette, Louise Gresham, Brandon Ramchatesingh, Margaret Redpath, May Chergui, Ivan V Litvinov\",\"doi\":\"10.1177/12034754241302821\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Reflex molecular testing, the process of profiling specimens at diagnosis, is emerging in oncology, allowing for prompt therapy initiation, and potentially improving outcomes. 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引用次数: 0
摘要
背景:反射分子检测,在诊断时分析标本的过程,正在肿瘤学中出现,允许及时开始治疗,并可能改善结果。本研究在麦吉尔大学健康中心(MUHC)评估反射性BRAF检测对黑色素瘤、肺癌和结直肠癌治疗时间和结果的影响。方法:在MUHC进行回顾性图表回顾。该研究包括2017年至2022年接受BRAF检测的黑色素瘤、肺癌和结直肠癌患者。提取了人口统计学、癌症类型、分期、检测排序专家、检测方法和治疗结果的数据。统计分析包括描述性和多元回归分析。结果:共进行518例BRAF分子检测,173例患者符合纳入标准[中位年龄72岁(IQR 60-80岁),女性46.2%]。其中,75.7%患有黑色素瘤,23.7%患有结直肠癌,0.58%患有肺癌。病理学家安排了71.1%的BRAF检测,主要依靠免疫组织化学。到2022年,所有BRAF结果都可以在肿瘤会诊前获得。会诊前BRAF结果的患者更有可能接受靶向治疗(59.4% vs 36.4%)。BRAF检测结果的可用性与更快的治疗开始和更好的治疗与突变状态的一致性有关。结论:本研究强调了MUHC病理团队在实施反射性BRAF突变检测方面的成功,通过确保检测结果的及时可用性来加强临床护理。检测的延迟可能会对临床决策和治疗选择产生不利影响,因此加拿大需要标准化的反射检测方案来优化黑色素瘤、肺癌和结直肠癌患者的预后。
Evaluating the Implementation and Impact of BRAF Reflex Mutation Testing in Melanoma, Lung, and Colorectal Cancers.
Background: Reflex molecular testing, the process of profiling specimens at diagnosis, is emerging in oncology, allowing for prompt therapy initiation, and potentially improving outcomes. This study evaluates the impact of reflex BRAF testing on treatment timelines and outcomes in melanoma, lung and colorectal cancers at the McGill University Health Center (MUHC).
Methods: A retrospective chart review was conducted at the MUHC. The study included patients with melanoma, lung, and colorectal cancers who underwent BRAF testing from 2017 to 2022. Data on demographics, cancer type, stage, test ordering specialist, testing method, and treatment outcomes were extracted. Statistical analyses included descriptive and multivariate regression analyses.
Results: 518 BRAF molecular tests were performed, with 173 patients meeting the inclusion criteria [median age 72 (IQR 60-80 years), 46.2% female]. Of these, 75.7% had melanoma, 23.7% colorectal cancer and 0.58% lung cancer. Pathologists ordered 71.1% of BRAF tests, primarily relying on immunohistochemistry. By 2022, all BRAF results were available before oncology consultations. Patients with pre-consultation BRAF results were more likely to receive targeted therapy (59.4% vs 36.4%). The availability of BRAF test results was associated with quicker treatment initiation and better alignment of therapy with mutation status.
Conclusion: This study underscores the success of the pathology team at MUHC in implementing reflex BRAF mutation testing, enhancing clinical care by ensuring the timely availability of test results. Delays in testing may adversely affect clinical decision-making and therapy selection, highlighting the need for standardized reflex testing protocols across Canada to optimize patient outcomes in melanoma, lung, and colorectal cancers.
期刊介绍:
Journal of Cutaneous Medicine and Surgery (JCMS) aims to reflect the state of the art in cutaneous biology and dermatology by providing original scientific writings, as well as a complete critical review of the dermatology literature for clinicians, trainees, and academicians. JCMS endeavours to bring readers cutting edge dermatologic information in two distinct formats. Part of each issue features scholarly research and articles on issues of basic and applied science, insightful case reports, comprehensive continuing medical education, and in depth reviews, all of which provide theoretical framework for practitioners to make sound practical decisions. The evolving field of dermatology is highlighted through these articles. In addition, part of each issue is dedicated to making the most important developments in dermatology easily accessible to the clinician by presenting well-chosen, well-written, and highly organized information in a format that is interesting, clearly presented, and useful to patient care.