Pediatric oncologist willingness to offer germline TP53 testing in osteosarcoma. Issue 6 (3rd January 2018)

• Record Type: Journal Article
• Authors: Shaul, Eliana; Roth, Michael; Lo, Yungtai; Geller, David S.; Hoang, Bang; Yang, Rui; Malkin, David; Gorlick, Richard; Gill, Jonathan
• Is Part Of: Cancer. Volume 124:Issue 6(2018)
• Page Start: 1242
• Page End: 1250
• Publication Date: 2018-01-03
• Subjects: Li‐Fraumeni syndrome -- osteosarcoma -- pediatrics -- practice patterns -- TP53; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.31212
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Li‐Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by mutations in the tumor‐suppressor gene TP53 . Osteosarcoma is a sentinel cancer in LFS. Prior studies using Sanger sequencing platforms have demonstrated that 3% of individuals with osteosarcoma harbor a mutation in TP53 . New data from next‐generation sequencing have demonstrated that 3.8% of patients with osteosarcoma have a known pathogenic variant, and an additional 5.7% carry exonic variants of unknown significance in TP53 . METHODS: Pediatric oncologists were e‐mailed an anonymous 18‐question survey assessing their willingness to offer TP53 germline testing to a child with osteosarcoma with or without a family history, and they were evaluated for changes in their choices with the prior data and the new data. RESULTS: One hundred seventy‐seven pediatric oncologists (22%) responded to the survey. Respondents were more likely to offer TP53 testing to a patient with a positive family history (77.4% vs 12.4%; P < .0001). Significantly more providers responded that they would offer TP53 testing once they were provided with the new data (25.4% vs 12.4%; P = .0038). The proportion of providers who responded that they were unsure increased significantly when they were presented with the new data (25.4% vs 10.2%; P = .0002). Potential implications for other family members and the possibility that surveillance imaging would detect new malignancies at an earlier stage were important factors influencing a provider's decision to offer TP53 testing. CONCLUSIONS: Recent data increase the proportion of providers willing to offer testing, and this suggests concern on the part of pediatric oncologists that variants of unknown significance may be disease‐defining in rare cancers. Cancer 2018;124:1242‐50 . © 2018 American Cancer Society . Abstract : In this survey, pediatric oncologists, when informed about recent data demonstrating that a higher than previously reported percentage of patients diagnosed with osteosarcoma harbor germline aberrations in TP53, increase their propensity to offer germline genetic testing to a sample patient with osteosarcoma.