The first Japanese nationwide multicenter study of BRCA mutation testing in ovarian cancer

CHARacterizing the cross-sectionaL approach to Ovarian cancer geneTic TEsting of BRCA (CHARLOTTE)

Takayuki Enomoto, Daisuke Aoki, Kana Hattori, Masahisa Jinushi, Junzo Kigawa, Nobuhiro Takeshima, Hitoshi Tsuda, Yoh Watanabe, Kosuke Yoshihara, Toru Sugiyama

Research output: Contribution to journalArticle

Abstract

Introduction BRCA gene mutations are associated with hereditary ovarian cancer. BRCA plays a key role in genome integrity, and mutations result in an increased risk for ovarian cancer. Although various guidelines recommend BRCA testing in patients with ovarian cancer, data on germline BRCA (gB RCA) mutation frequency in ovarian cancer in Japan are scarce. Objective This study aimed to determine gBRCA1/2 mutations in Japanese patients with ovarian cancer, stratified by clinicopathological characteristics, and to assess patients' satisfaction with pre-test genetic counseling. Methods The CHARLOTTE study (CHARacterizing the cross-sectionaL approach to Ovarian cancer: geneTic TEsting of BRCA; UMIN000025597) is the first large multicenter epidemiological survey of Japanese women, aged ≥20, with newly diagnosed ovarian cancer (epithelial, primary peritoneal, or fallopian tube cancer), with histologically confirmed specimens. Patients were enrolled sequentially and underwent pre-test genetic counseling for BRCA testing. Blood samples were centrally tested for the presence or absence of known gBRCA mutations. A questionnaire was used to assess patient satisfaction with pre-test genetic counseling. Results A total of 634 patients with a mean age of 56.9 years were included. Most patients (84.2%) had epithelial ovarian cancer, and 51.1% had FIGO stage III-IV cancer. Nearly all patients (99.5%) received genetic counseling before the BRCA testing, either by an obstetrician-gynecologist (42.0%) or a clinical geneticist (42.0%). The overall prevalence of gBRCA1/2 mutations was 14.7% (93/634), with gBRCA1 mutations (9.9%) more common than gBRCA2 mutations (4.7%). High-grade serous carcinoma showed a prevalence of gBRCA mutations of 28.5%. Most patients were satisfied with pre-test counseling, irrespective of the service provider's professional position. Discussion Patients with high-grade serous carcinoma and family history of ovarian cancer had a slightly higher prevalence of gBRCA mutations, but none of the subgroups had considerably high gBRCA mutation prevalence. These data suggest that gBRCA testing should be carried out in all patients with ovarian cancer.

Original languageEnglish
Pages (from-to)1043-1049
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume29
Issue number6
DOIs
Publication statusPublished - 2019 Jul 1

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Genetic Testing
Ovarian Neoplasms
Multicenter Studies
Mutation
Genetic Counseling
Patient Satisfaction
Fallopian Tube Neoplasms
Carcinoma
Germ-Line Mutation
Mutation Rate
Counseling
Japan
Cross-Sectional Studies
Genome
Guidelines

Keywords

  • BRCA
  • cross-sectional study
  • genetic testing
  • japanese
  • ovarian cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

The first Japanese nationwide multicenter study of BRCA mutation testing in ovarian cancer : CHARacterizing the cross-sectionaL approach to Ovarian cancer geneTic TEsting of BRCA (CHARLOTTE). / Enomoto, Takayuki; Aoki, Daisuke; Hattori, Kana; Jinushi, Masahisa; Kigawa, Junzo; Takeshima, Nobuhiro; Tsuda, Hitoshi; Watanabe, Yoh; Yoshihara, Kosuke; Sugiyama, Toru.

In: International Journal of Gynecological Cancer, Vol. 29, No. 6, 01.07.2019, p. 1043-1049.

Research output: Contribution to journalArticle

Enomoto, Takayuki ; Aoki, Daisuke ; Hattori, Kana ; Jinushi, Masahisa ; Kigawa, Junzo ; Takeshima, Nobuhiro ; Tsuda, Hitoshi ; Watanabe, Yoh ; Yoshihara, Kosuke ; Sugiyama, Toru. / The first Japanese nationwide multicenter study of BRCA mutation testing in ovarian cancer : CHARacterizing the cross-sectionaL approach to Ovarian cancer geneTic TEsting of BRCA (CHARLOTTE). In: International Journal of Gynecological Cancer. 2019 ; Vol. 29, No. 6. pp. 1043-1049.
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abstract = "Introduction BRCA gene mutations are associated with hereditary ovarian cancer. BRCA plays a key role in genome integrity, and mutations result in an increased risk for ovarian cancer. Although various guidelines recommend BRCA testing in patients with ovarian cancer, data on germline BRCA (gB RCA) mutation frequency in ovarian cancer in Japan are scarce. Objective This study aimed to determine gBRCA1/2 mutations in Japanese patients with ovarian cancer, stratified by clinicopathological characteristics, and to assess patients' satisfaction with pre-test genetic counseling. Methods The CHARLOTTE study (CHARacterizing the cross-sectionaL approach to Ovarian cancer: geneTic TEsting of BRCA; UMIN000025597) is the first large multicenter epidemiological survey of Japanese women, aged ≥20, with newly diagnosed ovarian cancer (epithelial, primary peritoneal, or fallopian tube cancer), with histologically confirmed specimens. Patients were enrolled sequentially and underwent pre-test genetic counseling for BRCA testing. Blood samples were centrally tested for the presence or absence of known gBRCA mutations. A questionnaire was used to assess patient satisfaction with pre-test genetic counseling. Results A total of 634 patients with a mean age of 56.9 years were included. Most patients (84.2{\%}) had epithelial ovarian cancer, and 51.1{\%} had FIGO stage III-IV cancer. Nearly all patients (99.5{\%}) received genetic counseling before the BRCA testing, either by an obstetrician-gynecologist (42.0{\%}) or a clinical geneticist (42.0{\%}). The overall prevalence of gBRCA1/2 mutations was 14.7{\%} (93/634), with gBRCA1 mutations (9.9{\%}) more common than gBRCA2 mutations (4.7{\%}). High-grade serous carcinoma showed a prevalence of gBRCA mutations of 28.5{\%}. Most patients were satisfied with pre-test counseling, irrespective of the service provider's professional position. Discussion Patients with high-grade serous carcinoma and family history of ovarian cancer had a slightly higher prevalence of gBRCA mutations, but none of the subgroups had considerably high gBRCA mutation prevalence. These data suggest that gBRCA testing should be carried out in all patients with ovarian cancer.",
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AU - Aoki, Daisuke

AU - Hattori, Kana

AU - Jinushi, Masahisa

AU - Kigawa, Junzo

AU - Takeshima, Nobuhiro

AU - Tsuda, Hitoshi

AU - Watanabe, Yoh

AU - Yoshihara, Kosuke

AU - Sugiyama, Toru

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N2 - Introduction BRCA gene mutations are associated with hereditary ovarian cancer. BRCA plays a key role in genome integrity, and mutations result in an increased risk for ovarian cancer. Although various guidelines recommend BRCA testing in patients with ovarian cancer, data on germline BRCA (gB RCA) mutation frequency in ovarian cancer in Japan are scarce. Objective This study aimed to determine gBRCA1/2 mutations in Japanese patients with ovarian cancer, stratified by clinicopathological characteristics, and to assess patients' satisfaction with pre-test genetic counseling. Methods The CHARLOTTE study (CHARacterizing the cross-sectionaL approach to Ovarian cancer: geneTic TEsting of BRCA; UMIN000025597) is the first large multicenter epidemiological survey of Japanese women, aged ≥20, with newly diagnosed ovarian cancer (epithelial, primary peritoneal, or fallopian tube cancer), with histologically confirmed specimens. Patients were enrolled sequentially and underwent pre-test genetic counseling for BRCA testing. Blood samples were centrally tested for the presence or absence of known gBRCA mutations. A questionnaire was used to assess patient satisfaction with pre-test genetic counseling. Results A total of 634 patients with a mean age of 56.9 years were included. Most patients (84.2%) had epithelial ovarian cancer, and 51.1% had FIGO stage III-IV cancer. Nearly all patients (99.5%) received genetic counseling before the BRCA testing, either by an obstetrician-gynecologist (42.0%) or a clinical geneticist (42.0%). The overall prevalence of gBRCA1/2 mutations was 14.7% (93/634), with gBRCA1 mutations (9.9%) more common than gBRCA2 mutations (4.7%). High-grade serous carcinoma showed a prevalence of gBRCA mutations of 28.5%. Most patients were satisfied with pre-test counseling, irrespective of the service provider's professional position. Discussion Patients with high-grade serous carcinoma and family history of ovarian cancer had a slightly higher prevalence of gBRCA mutations, but none of the subgroups had considerably high gBRCA mutation prevalence. These data suggest that gBRCA testing should be carried out in all patients with ovarian cancer.

AB - Introduction BRCA gene mutations are associated with hereditary ovarian cancer. BRCA plays a key role in genome integrity, and mutations result in an increased risk for ovarian cancer. Although various guidelines recommend BRCA testing in patients with ovarian cancer, data on germline BRCA (gB RCA) mutation frequency in ovarian cancer in Japan are scarce. Objective This study aimed to determine gBRCA1/2 mutations in Japanese patients with ovarian cancer, stratified by clinicopathological characteristics, and to assess patients' satisfaction with pre-test genetic counseling. Methods The CHARLOTTE study (CHARacterizing the cross-sectionaL approach to Ovarian cancer: geneTic TEsting of BRCA; UMIN000025597) is the first large multicenter epidemiological survey of Japanese women, aged ≥20, with newly diagnosed ovarian cancer (epithelial, primary peritoneal, or fallopian tube cancer), with histologically confirmed specimens. Patients were enrolled sequentially and underwent pre-test genetic counseling for BRCA testing. Blood samples were centrally tested for the presence or absence of known gBRCA mutations. A questionnaire was used to assess patient satisfaction with pre-test genetic counseling. Results A total of 634 patients with a mean age of 56.9 years were included. Most patients (84.2%) had epithelial ovarian cancer, and 51.1% had FIGO stage III-IV cancer. Nearly all patients (99.5%) received genetic counseling before the BRCA testing, either by an obstetrician-gynecologist (42.0%) or a clinical geneticist (42.0%). The overall prevalence of gBRCA1/2 mutations was 14.7% (93/634), with gBRCA1 mutations (9.9%) more common than gBRCA2 mutations (4.7%). High-grade serous carcinoma showed a prevalence of gBRCA mutations of 28.5%. Most patients were satisfied with pre-test counseling, irrespective of the service provider's professional position. Discussion Patients with high-grade serous carcinoma and family history of ovarian cancer had a slightly higher prevalence of gBRCA mutations, but none of the subgroups had considerably high gBRCA mutation prevalence. These data suggest that gBRCA testing should be carried out in all patients with ovarian cancer.

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