Genetic testing for cancer is always evolving to help doctors provide the best treatment.
A genetic test can be used to determine the best treatment for a disorder. For example, a genetic test of a person’s cancer can be used to identify those cancers which are likely to respond to a particular drug treatment.
On 1st February 2017, a new genetic test will be added to the Medicare Benefits Schedule (MBS) that helps women with advanced ovarian cancer.
This test identifies women whose ovarian cancer is likely to respond to a chemotherapy drug called olaparib.
This new test accompanies the new listing of olaparib on the Pharmaceutical Benefits Scheme (PBS). Until now the drug has been largely inaccessible in Australia due to cost.
Both the new test and the new drug will become more readily available to Australians as they are now subsidised under Medicare for eligible patients.
The test examines the woman’s BRCA1 and BRCA2 genes. Women who have an inherited error in either gene are more likely to have a cancer which will respond to olaparib.
Dr Melody Caramins, an ambassador for Pathology Awareness Australia, was thrilled to hear of the upcoming addition to the MBS;
“This news will bring tremendous hope to women at an unbelievably stressful time in their life. Previously, the cost of the drug would have been prohibitive to many women, especially on top of their other out of pocket costs for investigations and monitoring.”
The drug is not proven to be effective for women without the BRCA gene mutation. Therefore it was only recommended as economically viable on the basis that a companion diagnostic test be made available that would determine if a woman was suitable or not. Dr Caramins said;
“By using BRCA testing before administering olaparib to the patient, doctors can avoid prescribing the drug to a woman who is unlikely to benefit from it, therefore saving them unnecessary treatment and side effects. Not to mention we avoid wasting healthcare dollars on ineffective treatment.
“By increasing the availability of these kinds of companion diagnostics we are opening up new channels of life-saving treatment for Australians. And that’s fantastic news all round.”
In patients who respond to treatment, olaparib can increase survival time almost threefold and improve quality of life for patients as it has less side effects than current treatments.
In addition to predicting the response to treatment, genetic testing can also be used to predict the risk of disease, including the risk among family members.
An application to add genetic testing for familial ovarian and breast cancer to the MBS has now cleared a major hurdle, with funding recommended by the Medical Services Advisory Committee (MSAC) of the Federal Department of Health. This recommendation is currently under consideration by the Minister of Health.
An inherited error in one of several genes, including BRCA1 and BRCA2, can place a woman at increased risk of developing breast and ovarian cancer. If a woman is affected by breast or ovarian cancer, a doctor can use her personal and family history to assess whether she is likely to have such a mutation and recommend that she be tested. If approved by the Minister, the cost of testing would be covered by Medicare.
For the affected woman, the identification of a mutation would place her at increased risk of developing breast or ovarian cancer a second time, and she can take specific precautions to reduce the risk of this occurring.
For the woman’s relatives, the impact is even greater. When a mutation is found, family members can have testing to clarify their own risk of developing breast and ovarian cancer – and of passing the same mutation on to their children. Female relatives with a mutation can take specific precautions to reduce the chance of a serious cancer diagnosis, while those who have not inherited the mutation can be spared unnecessary screening and anxiety.