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Tytuł:
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The Implications of Genetic Testing on Radiation Therapy Decisions: A Guide for Radiation Oncologists.
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Autorzy:
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Bergom C; Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
West CM; Division of Cancer Sciences, National Institute for Health Research Manchester Biomedical Research Centre, University of Manchester, Christie National Health Service Foundation Trust Hospital, Manchester, UK.
Higginson DS; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Abazeed ME; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio; Department of Translational Hematology Oncology Research, Cleveland Clinic, Cleveland, Ohio.
Arun B; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Bentzen SM; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
Bernstein JL; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Evans JD; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota; Department of Radiation Oncology and Precision Genomics, Intermountain Healthcare, Ogden, Utah.
Gerber NK; Department of Radiation Oncology, New York University Langone Health, New York, New York.
Kerns SL; Department of Radiation Oncology, University of Rochester, Rochester, New York.
Keen J; Scientific Affairs, American Society for Radiation Oncology, Arlington, Virginia.
Litton JK; Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Reiner AS; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
Riaz N; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Rosenstein BS; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York.
Sawakuchi GO; Department of Radiation Physics The University of Texas MD Anderson Cancer Center, Houston, Texas.
Shaitelman SF; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Powell SN; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Woodward WA; Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: .
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Źródło:
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International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2019 Nov 15; Vol. 105 (4), pp. 698-712. Date of Electronic Publication: 2019 Aug 02.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't; Review
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Język:
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English
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Imprint Name(s):
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Publication: New York, NY : Elsevier, Inc
Original Publication: Elmsford, N. Y., Pergamon Press.
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MeSH Terms:
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Genetic Testing*
Mutation*
Radiation Oncologists*
Neoplasms/*genetics
Neoplasms/*radiotherapy
Radiation Tolerance/*genetics
Adult ; Ataxia Telangiectasia/genetics ; Ataxia Telangiectasia Mutated Proteins/genetics ; Clinical Decision-Making ; Consensus ; DNA Repair/genetics ; Genes, BRCA1 ; Genes, BRCA2 ; Genetic Variation ; Germ-Line Mutation ; Health Care Surveys ; Heterozygote ; Humans ; Neoplasms, Radiation-Induced/genetics ; Neoplasms, Second Primary/genetics ; Syndrome ; Terminology as Topic
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Grant Information:
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18504 United Kingdom CRUK_ Cancer Research UK; K07 CA187546 United States CA NCI NIH HHS
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Substance Nomenclature:
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EC 2.7.11.1 (ATM protein, human)
EC 2.7.11.1 (Ataxia Telangiectasia Mutated Proteins)
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Entry Date(s):
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Date Created: 20190806 Date Completed: 20200131 Latest Revision: 20240210
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Update Code:
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20240210
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DOI:
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10.1016/j.ijrobp.2019.07.026
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PMID:
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31381960
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The advent of affordable and rapid next-generation DNA sequencing technology, along with the US Supreme Court ruling invalidating gene patents, has led to a deluge of germline and tumor genetic variant tests that are being rapidly incorporated into clinical cancer decision-making. A major concern for clinicians is whether the presence of germline mutations may increase the risk of radiation toxicity or secondary malignancies. Because scarce clinical data exist to inform decisions at this time, the American Society for Radiation Oncology convened a group of radiation science experts and clinicians to summarize potential issues, review relevant data, and provide guidance for adult patients and their care teams regarding the impact, if any, that genetic testing should have on radiation therapy recommendations. During the American Society for Radiation Oncology workshop, several main points emerged, which are discussed in this manuscript: (1) variants of uncertain significance should be considered nondeleterious until functional genomic data emerge to demonstrate otherwise; (2) possession of germline alterations in a single copy of a gene critical for radiation damage responses does not necessarily equate to increased risk of radiation-induced toxicity; (3) deleterious ataxia-telangiesctasia gene mutations may modestly increase second cancer risk after radiation therapy, and thus follow-up for these patients after indicated radiation therapy should include second cancer screening; (4) conveying to patients the difference between relative and absolute risk is critical to decision-making; and (5) more work is needed to assess the impact of tumor somatic alterations on the probability of response to radiation therapy and the potential for individualization of radiation doses. Data on radiosensitivity related to specific genetic mutations is also briefly discussed.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
