Paula Anastasia Emphasizes Importance of Genetic Testing in Selecting Maintenance Therapy for Ovarian Cancer

All women with ovarian cancer should receive genetic testing, according to Paula Anastasia, RN, MN, AOCN. However, certain actionable targets may be missed depending on the tests ordered in the clinic.

“When we talk about genetic testing, germline testing, now we want panel testing because in addition to the BRCA1 and BRCA2 pathogenic variants, there are other pathogenic variants in that family [such as] RAD51 and BRIP1,” says Anastasia, who notes that for nurses working at institutions without genetic counselors onsite, there are valuable genetic counselor services online, which not only provide tests but help contextualize the results for providers and patients alike.

Anastasia recently gave a talk on PARP inhibitor optimization as part of the 6th Annual School of Nursing Oncology™ Meeting. Ahead of the conference, she met with Oncology Nursing News® to discuss what nurses need to know about this class of agents.

There are 2 approved PARP inhibitors for ovarian maintenance therapy, Anastasia says. However, it is important to determine if a patient has a homologous recombination deficiency (HRD) to see if they are eligible for a PARP inhibitor, she adds, noting that studies have shown that patients with a germline mutation or an HRD-positive tumor have a better clinical benefit with a PARP inhibitor.

Lastly, Anastasia underscores the importance of a patient’s prior adverse effect profile from chemotherapy.

“We want to know: how did patients do with their frontline therapy?” she explains. “Did they require growth factors? Was there dose reduction? Do patients have a history of hypertension, which may indicate whether or not they would tolerate something like niraparib?”

All of these are important considerations, she concludes.