Multigene Panel Testing for Hereditary Cancer Risk

Abstract

A continuing education article for nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematology nurses. Historically, an understanding of a patient and/or their family's cancer risk and predisposition was based in large part on patient pedigree or family history, histology, and age at diagnosis. However, since the completion of the Human Genome Project, advances in technology have moved from pedigree to single-gene testing to multigene testing and next-generation sequencing. Advanced practitioners need to follow developments in genetic testing to interpret results, ensure that their patients/families receive appropriate counseling before and after testing, understand the clinical impact of genetic testing across the trajectory of healthcare, including surveillance, screening, diagnosis, treatment, lifestyle, pharmacogenomics, and new targeted therapies. Advanced practitioners also need to recognize ethical challenges, limitations, and/or barriers to genetic testing. This article provides an overview of multigene panel testing for hereditary cancer risk and offers two case examples to highlight the clinical considerations, benefits, limitations, and insurance challenges encompassed in this new approach to genetic testing. The activity's target audience will consist of nurse practitioners, clinical nurse specialists, advanced degree nurses, and oncology and hematology nurses. Learning Objectives After completing this educational activity, participants should be able to: 1. Describe the difference between sequential single-gene testing vs. multigene testing 2. Discuss the role of multigene testing in hereditary cancer risk 3. Explain some of the limitations of multigene testing 4. Identify potential barriers to multigene testing regarding insurance coverage Continuing Education Statement of Credit—Participants who successfully complete this activity (including the submission of the post-test and evaluation form) will receive a statement of credit. All individuals in positions to control the content of this program (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Meniscus Educational Institute has identified and resolved all conflicts of interest in accordance with the MEI policies and procedures. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity. FACULTY Alyssa A. Grissom, MSN, APN, AGCNS, OCN