Główne pojęcia
Genetic testing for homologous recombination repair (HRR) mutations is underutilized in patients with metastatic castration-resistant prostate cancer (mCRPC) in the United States, despite its potential prognostic and predictive value for targeted therapies.
Streszczenie
The study examined the utilization of genetic testing for HRR mutations among 9,395 patients with mCRPC in the United States between 2014 and 2022. The key findings are:
- Only 37.7% of patients received HRR mutation testing, with the majority (62.3%) not undergoing the test.
- The proportion of patients tested peaked in 2020 at 55.5%, with a slight decline after 2020, possibly due to the COVID-19 pandemic.
- From 2014 to 2019, 74% of tested patients and 23% of all patients underwent the test more than 12 weeks after initiating first-line therapy. However, the timing of testing improved in 2020, with 92% of tested patients and 46% of all patients receiving the test within 12 weeks of starting first-line therapy.
- Factors associated with lower odds of HRR testing included being diagnosed before 2018, no prior treatment for localized disease, poorer performance status, de novo disease, lower socioeconomic status, Medicaid insurance, treatment outside academic centers, and older age.
- The authors highlight that the low testing rates would further limit the utilization of targeted therapies among eligible patients.
Statystyki
37.7% of patients (3,538 of 9,395) received HRR mutation testing.
From 2014 to 2019, 74% of tested patients (1,546 of 2,090) and 23% of all patients (1,546 of 6,688) underwent the test more than 12 weeks after initiating first-line therapy.
In 2020, 92% of tested patients (304 of 327) and 46% of all patients (304 of 662) received the test within 12 weeks of starting first-line therapy.
Cytaty
"These findings highlight disparities in receiving HRR testing in the US."
"While the use of genomic-based therapies was not the focus of this study, the low testing rates observed in our cross-sectional study would be further compounded by low utilization of targeted therapies among patients who are known to be eligible."