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Clinical Impact of Enhanced Risk Assessments in Women With a BRCA1/2 Mutation, CARE Study

Not Applicable
Active, not recruiting
Conditions
BRCA1/2-Associated Hereditary Breast and Ovarian Cancer Syndrome
Interventions
Procedure: Biospecimen Collection
Other: Best Practice
Other: Counseling
Procedure: Discussion
Other: Questionnaire Administration
Procedure: Genotyping
Procedure: Molecular Risk Assessment
Registration Number
NCT06534424
Lead Sponsor
Ohio State University Comprehensive Cancer Center
Brief Summary

This clinical trial evaluates the impact of enhanced risk assessments on knowledge, perceptions, and decisional conflict about cancer prevention in women with a BRCA1 or BRCA2 mutation. BRCA1/2 mutation carriers have a much higher risk of developing breast and ovarian cancer. Due to the high risk of cancer, mutation carriers are provided guidelines on more intensive screening and preventative surgeries such as bilateral mastectomy and bilateral salpingo-oophorectomy. Doctors want to learn if a more personalized risk assessment impacts the patients' risk perceptions and comfort with decision-making around cancer prevention behaviors.

Detailed Description

PRIMARY OBJECTIVES:

I. To deploy tools for delivering enhanced genetic risk predictions based on BRCA1/2 genetic risk modifiers in a clinical setting and assess the impact of risk stratification on genetic knowledge, risk perceptions and decisional conflict regarding cancer prevention decision-making.

II. To perform long-term follow-up of individuals in the randomized controlled trial (RCT) to determine if there are differences in satisfaction, decision-making and outcomes in individuals who received standard versus enhanced genetic risk predictions over time.

OUTLINE: Patients undergo collection of blood or mouthwash samples. Patients are then randomized to 1 of 2 arms.

ARM I: Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.

ARM II: 4-8 weeks later, patients receive a standard follow-up phone call.

After completion of study intervention, patients are followed up for 2 years.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
152
Inclusion Criteria
  • Have had genetic counseling and testing for mutations in BRCA1 and/or BRCA2 through a Clinical Laboratory Improvement Act (CLIA)-certified laboratory
  • Were found to have a known pathogenic mutation upon testing
  • Are within 3 weeks of results disclosure
  • Have available medical records for ascertainment of clinical information
  • Are able to provide a source of deoxyribonucleic acid (DNA) (blood or mouthwash) for study
  • Have access to a telephone and a computer or other internet-ready device
  • Have not yet had a bilateral prophylactic mastectomy or bilateral Salpingo oophorectomy
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm II (standard)Questionnaire AdministrationPatients undergo collection of blood or mouthwash samples. 4-8 weeks later, patients receive a standard follow-up phone call.
Arm I (enhanced risk assessment)Molecular Risk AssessmentPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm I (enhanced risk assessment)Biospecimen CollectionPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm I (enhanced risk assessment)CounselingPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm II (standard)DiscussionPatients undergo collection of blood or mouthwash samples. 4-8 weeks later, patients receive a standard follow-up phone call.
Arm I (enhanced risk assessment)DiscussionPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm I (enhanced risk assessment)GenotypingPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm I (enhanced risk assessment)Questionnaire AdministrationPatients undergo collection of blood or mouthwash samples. Patients undergo genotyping with enhanced risk assessment on study. 4 to 8 weeks later, patients receive a follow-up phone call for return of enhanced risk assessment results and tailored counseling.
Arm II (standard)Best PracticePatients undergo collection of blood or mouthwash samples. 4-8 weeks later, patients receive a standard follow-up phone call.
Arm II (standard)Biospecimen CollectionPatients undergo collection of blood or mouthwash samples. 4-8 weeks later, patients receive a standard follow-up phone call.
Primary Outcome Measures
NameTimeMethod
Decisional conflict Regarding Cancer Risk ManagementUp to 3 months

Decisional conflict regarding cancer risk management will be measured via a questionnaire. Comparison of this measure between the enhanced and standard arms adjusting for stratified randomization will be made using linear regression. The alpha level for the outcome will be 0.05.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Ohio State University Comprehensive Cancer Center

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Columbus, Ohio, United States

Huntsman Cancer Institute/University of Utah

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Salt Lake City, Utah, United States

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