NCCN Updates Genetic Testing Guidelines

New, more specific suggestions for testing pancreatic cancer patient are included
Robert Calandra

The National Comprehensive Cancer Network (NCCN) has updated its recommendations for genetic testing in breast, ovarian, and pancreatic cancer, according to MedPage Today.

NCCN began issuing its guidelines in 1999, shortly after the discovery of the BRCA genes. Since then the panel has been testing multiple genes at the same time as it finds mutations. The revised guidelines reflect those new findings. 

“It updates the risk information about some of the newer genes,” Robert Pilarski, LGC, of the Ohio State University Comprehensive Cancer Center in Columbus, told MedPage.“It also expands to include cancer risk, which had been touched on within the context of the BRCA genes, but now it stands alone to reflect that there are other genes that are appropriate for testing."

The new recommendations rely on evidence-base criteria that focus on the strength of data. The data narrows the search for specific mutations in some cases but also includes as many patients as possible when a potential benefit exists, MedPage reported.

While expanding inclusion, the new guidelines also concentrate on simplification of testing and state that testing might be clinically indicated if the test results are expected to influence decision making about systemic therapy.

Organized by disease and syndrome type, the updated guidelines also streamline information about appropriate subsequent steps for people who meet genetic testing criteria and also extensively revises introduction principles and practices of genetic testing to reflect the growing complexity of testing options and decisions.

Matthew Yurgelun at DFCI

The guidelines go beyond a general recommendation for genetic testing for all patients with pancreatic cancer to include more information about specific genes associated with pancreatic cancer. Recent data has shown that between 4% and 10% of patients with pancreatic cancer have inherited genetic mutations, said Matthew B. Yurgelun, MD, of Dana-Farber Cancer Institute in Boston and a guideline panelist.

"Based off these data, there is now a compelling reason for all individuals with pancreatic cancer to be offered genetic counseling and germline testing for such variants, particularly given the possibility that their at-risk family members could greatly benefit from known, effective cancer risk-reducing interventions," he said.