Germline and Somatic Testing for Ovarian Cancer: An SGO Clinical Practice Statement

The SGO Clinical Practice Committee recently published, “Germline and somatic testing for ovarian cancer: An SGO clinical practice statement,” intended to provide an overview of available testing modalities that can influence therapeutic decisions and care delivery for patients with epithelial ovarian cancer. The practice statement appears in the February issue of Gynecologic Oncology.

In the landscape of ovarian cancer treatment, genetic testing has emerged as a pivotal tool, offering insights that can shape therapeutic decisions and prognostic outlooks. Despite its potential to revolutionize care, universal genetic testing remains underutilized, particularly among underserved populations. 

The clinical practice statement recommends that all patients with epithelial ovarian cancer be offered germline genetic testing; however, according to co-lead author, Gregory Gressel, MD, MSc, FACOG, of Spectrum Health Cancer Center, there are many systemic barriers hindering universal germline testing. “Provider awareness, heterogeneity of practice, lack of institutional resources, and socioeconomic disparities among underserved populations” are significant challenges, he notes. With this statement, the Clinical Practice Committee hopes to underscore the importance of universal germline genetic testing to address the high rate of pathogenic germline variants in the patient population. 

Mainstreaming genetic counseling is a complex and multifaceted process that requires extensive partnership. Co-lead author, Melissa Frey, MD, of Weill Cornell Medicine, suggests “close collaboration between providers interested in offering real-time genetic testing/counseling and genetic experts willing to invest time to train these providers” as a starting point. Dr. Gressel also suggests the development of online training programs specifically designed to provide genetic medical education to interested non-physician clinical team members. 

The implications of universal genetic testing extend beyond targeted care for individual patients. Drs. Gressel and Frey underscore that genetic insights also enable cascade testing that allows clinicians to identify at-risk relatives. Cascade testing enables them to pursue interventions such as breast cancer screening and risk-reducing surgery. Employing genetic testing as a proactive approach holds promise for early detection interventions, life-saving cancer preventions, and, ultimately, more effective ovarian cancer treatment. 

For more on this topic, tune in to the Association of Cancer Care Centers CANCER BUZZ podcast featuring clinical practice statement authors, Dr. Frey and Leigha Senter, MS, CGC, of The Ohio State University.