Closing the gap in germline testing in patients with cancer through a clinic-based awareness initiative: From booth to patient's agenda.

Abstract

1603 Background: Germline genetic testing (GT) is a standard of care for a broad range of patients (pts) diagnosed with cancer due to expanded guidelines and targeted treatments options. The consequent identification of hereditary cancer susceptibility syndromes (HCS) enables optimal surveillance measures, prophylactic interventions and the identification of at-risk family members. Unfortunately, GT rates in oncology are still low worldwide. Barriers are complex but commonly related to deferred appointments and overwhelmed pts. In Argentina, GT and genetic counseling (GC) have not been endorsed as a public health need, insurance coverage relies on a case-by-case basis and mainstreaming has not been fully implemented, therefore, integrating GT into oncology workflows remains a challenge. Methods: Our aim was to describe the impact on GT intake of an information campaign coupled with an appointment help desk in a cancer center. We conducted a high-risk, one-month awareness social media campaign, following a one-week, in-person, information booth (during 06/26/2024 -07/03/2024), strategically placed near the waiting room of a cancer center in Argentina. Both offered informative material and the possibility to attend a free, hybrid- mode, interactive, “meet the expert” session on 07/11/2024. For those who visited the booth, in-person orientation by health providers and scheduling for a personalized GC session (in person or by telemedicine) in the following 3 months was offered. After informed consent, information from social media, landing page interaction and medical records was extracted for analysis. Descriptive statistics with Stata program was performed. Results: On social media: ≥600 likes, ≥20 comments, ≥350 landing page visits, ≥278 interactions and 976 new e-mail contacts were registered in the landing page. A peak of 119 visits was recorded on 07/09/2024. Media engagement rate: 5,14 %. 814 individuals registered to the hybrid session with an attendance rate of 30% (245/814), with no differences related to format option (in-person 21/73: 29% and virtual 224/741: 30%, p-value 0.794954). At the booth: 165 pts requested in-person information, 160 were scheduled for a visit: first assessments (1As): 114/160 (71%). Compliance with appointment was 64% between 1As (73/114), GT was suggested to 92% of 1As (67/73) with GT intake of 49/73 (67%) by multi-gene germline panel. Overall, 10/160 HCS were identified (diagnostic yield in intention-to-treat): 6,5%: 3 gATM, 2 gBRCA1-2, 2 gHOXB13, 1 gCHEK2, 1 heterozygous MUTYH, 1 heterozygous FANCA. Risk-reducing surgeries were performed in 4/10 carriers. Conclusions: Social media engagement combined with lowering appointments barriers can achieve a high compliance to 1As genetic consultations, GT and consequently identification of HCS among high-risk pts with cancer in resource-limited scenarios.