Despite the OlympiA trial demonstrating that early-stage, high-risk, HER2- germline
BRCA1 and
BRCA2 mutation (g
BRCAm) positive breast cancer patients can benefit from PARPi in the adjuvant setting, the g
BRCA testing rate in early-stage HR+/HER2− patients remains suboptimal compared to that
[...] Read more.
Despite the OlympiA trial demonstrating that early-stage, high-risk, HER2- germline
BRCA1 and
BRCA2 mutation (g
BRCAm) positive breast cancer patients can benefit from PARPi in the adjuvant setting, the g
BRCA testing rate in early-stage HR+/HER2− patients remains suboptimal compared to that in early-stage TNBC patients. To better understand the perceived barriers associated with g
BRCA testing in HR+/HER2− disease, a quantitative survey was conducted across stakeholders (
n = 430) including medical oncologists, surgeons, nurses, physician assistants, payers, and patients. This study revealed that while payers claim to cover g
BRCA testing, poor clinician documentation and overutilization are key challenges. Therefore, payers place utilization management controls on g
BRCA testing due to their impression that clinicians overtest. These controls have led to healthcare professionals experiencing payer pushback in the form of reimbursement limitations and denials. The perceived challenges to g
BRCA testing stem from the lack of consensus dictating which patients are high risk and should be tested. While payers define high risk based on the CPS + EG score from the OlympiA trial, HCPs adopt a broader definition including genomic risk scores, lymph node involvement, and tumor grade and size. A dialogue to harmonize risk classification and testing eligibility across stakeholders is critical to address this disconnect and increase g
BRCA testing in appropriate patients.
Full article
