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)

Naidoo, M; Scott, CL; Lloyd, M; McNally, O; Rome, R; Perera, S; Zalcberg, JR

Author(s): Naidoo, M; Scott, CL; Lloyd, M; McNally, O; Rome, R; Perera, S; Zalcberg, JR;
Details: Publication Year 2025-07-31,Volume 17,Issue #15,Page 2541
Journal Title: Cancers
Publication Type: Research article
Abstract: Background: The identification of pathogenic variants in the Breast Cancer Genes 1 and 2 (BRCA1/2) is a critical predictive biomarker for poly (ADP-ribose) polymerase inhibitor (PARPi) therapy in epithelial ovarian cancer (EOC). The aim of this study is to define real-world rates and determinants of germline and somatic BRCA1/2 testing and subsequent PARPi utilisation in Australia using a national clinical quality registry. Methods: This multi-centre cohort study analysed data from 1503 women with non-mucinous EOC diagnosed between May 2017 and July 2022, captured by the Australian National Gynae-Oncology Registry (NGOR). We evaluated rates of germline and somatic testing and PARPi use, using multivariate logistic regression to identify associated clinical and demographic factors. Results: Overall germline and somatic testing rates were 68% and 32%, respectively. For the high-grade serous ovarian cancer (HGSOC) cohort, rates were higher, at 78% and 39%, respectively. Germline testing was significantly less likely for women aged >80 years (OR 0.49), those in regional areas (OR 0.61), and those receiving single-modality treatment. Somatic testing uptake increased significantly following public reimbursement for PARPi (p = 0.004). Among eligible women with a newly diagnosed BRCA pathogenic variant and advanced disease (n = 110), 52% commenced first-line maintenance PARPi. Conclusions: This national study offers valuable insights into Australian ovarian cancer care, highlighting opportunities to enhance testing equity for older women (aged >80) and regional patients. Furthermore, it identifies the translation of a positive test into PARPi therapy as a complex area that warrants further collaborative investigation to optimise patient outcomes.
Publisher: MDPI
Keywords: Australia; Brca; PARP inhibitors; clinical quality registry; health disparities; health services research; ovarian cancer; precision oncology
Department(s): Medical Oncology
Publisher's Version: https://doi.org/10.3390/cancers17152541
Open Access at Publisher's Site: https://doi.org/10.3390/cancers17152541
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-09-09 06:01:15

Last Modified: 2025-09-09 06:01:24