News in brief: ASCO’s five-year plan to enhance the wellbeing of oncologists; Who should catch the women who fall through the cancer genetic testing cracks?; No evidence BMI interferes with breast cancer preventive therapy

Medicines

9 Mar 2021

ASCO’s five-year plan to enhance the wellbeing of oncologists

ASCO has three goals to enhance the wellbeing of oncologists that it hopes will ultimately improve the quality of cancer care.

The five-year road map sets out plans to promote clinician well-being across ASCO activities; broaden and diversify resources that support well-being among oncology professionals, and promote research that identifies clinician and practice needs for optimal well-being.

“Ultimately, the plan aims for cancer care delivery in clinical and research environments where patients, clinicians, and practices thrive,” the professional body says.

Who should catch the women who fall through the cancer genetic testing cracks?

Guidelines for genetic testing have changed rapidly with increasing knowledge leaving women who would now benefit from testing out in the cold. But whose job is it to re-contact them?

Researchers from the Cancer Genetics Service at the Mid North Coast Cancer Institute, NSW found that of  237 women diagnosed with triple negative breast cancer (TNBC) at their centre between 2014-18, 13% (31/237) fulfilled criteria for genetic testing, with 81% (25/31) being referred to a cancer genetics service.

However, they identified that since the change in guidelines for women diagnosed with TNBC, 5% (11/237) of the total cohort would now meet criteria for genetic testing, but did not at their time of diagnosis.

Re-contacting these women about their updated genetic information could benefit the patients, but the authors noted that there was no consensus or procedures in place at present to guide service delivery in re-contacting patients.

“It is not clear whose responsibility it is to inform patients of updated genetic information. Is it the role of genetics services, specialist clinicians, general practitioners or the patients themselves? As per the Human Genetics Society of Australasia Clinical Genetics Service Framework, our services encourage patients to re-contact the service for updated information over time. Anecdotally, we find patients rarely re-contact our genetics services for updated information,” they wrote in their paper published in Hereditary Cancer in Clinical Practice.

No evidence BMI interferes with breast cancer preventive therapy

Women at increased risk of breast cancer who are taking preventive therapy are likely to experience benefit from tamoxifen and anastrozole regardless of their BMI, research suggests.

The researchers used data from the IBIS-I and II trials to estimate the relationship between BMI and breast cancer among women at increased risk of developing the disease.

In line with other studies BMI was positively associated with breast cancer risk among postmenopausal women, but no effect was seen in premenopausal women.

The research team from the UK noted that previous evidence had shown that overweight and obesity may reduce the efficacy of anastrozole but not tamoxifen, yet their data did not show any ‘convincing evidence’ to suggest this was the case.

“ Women are likely to experience benefit from tamoxifen and anastrozole preventive therapy regardless of their BMI. These data also indicate that preventive therapy is unlikely to completely mitigate the excess breast cancer risk among postmenopausal women with a higher BMI,” they wrote in Epidemiology.

“A complementary approach of weight management and preventive therapy may optimally reduce breast cancer risk in this population,” they added.

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