Cost-minimization analysis of germline and somatic testing strategies for BRCA mutations in women with newly diagnosed epithelial ovarian cancer

Abstract

Objective: The SOLO1 trial made it a priority to identify BRCA germline and somatic mutations in women with newly diagnosed epithelial ovarian cancer in order to determine candidates for olaparib maintenance. It is also important to differentiate between germline and somatic mutations because of the potential for cascade testing in relatives. Three testing strategies can be employed: (1) test all patients for germline mutations with reflex somatic testing if germline testing is negative; (2) test all tumors for somatic mutations with reflex germline testing if somatic testing is positive; or (3) perform simultaneous germline and somatic testing.