Trial of Combined Obstetric Carrier Screening and Hereditary Cancer Screening

NCT ID: NCT07052266

Last Updated: 2025-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

550 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-02

Study Completion Date

2028-12-31

Brief Summary

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The investigators hypothesize that pregnancy and preconception care may be a feasible and effective time to offer inherited cancer risk screening. This study will assess interest in cancer genetic testing among patients receiving routine prenatal or preconception/fertility care. The goal is to evaluate the acceptability of BRCA1/2 testing when offered alongside standard prenatal genetic screening. The study will also explore whether universal screening in this population could support early cancer prevention and be cost-effective, especially among underserved populations.

Detailed Description

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The purpose of this study is to prospectively offer obstetric patients combined hereditary cancer screening (HCS) and obstetric carrier screening (OCS) to see if patients decide they want HCS in addition to their OCS. Preconception and pregnancy represent a unique window of opportunity for women to engage and interact with the healthcare system. With the proposed trial, the investigators aim to change the paradigm of obstetrical-related genetic testing to include potentially life-saving HCS.

Approximately 25% of the general population in the U.S. meets established criteria to recommend genetic counseling and testing for hereditary cancer syndromes, but less than 1% of individuals undergo genetic testing. Furthermore, racial, ethnic, and linguistic minorities experience even greater under-recognition of familial cancer syndromes.This results in a critical missed opportunity for preventing cancer-associated morbidity and mortality. Obstetric care is a potential window of opportunity for addressing this issue, as pregnancy offers a unique opportunity for individuals to interact with the healthcare system. Importantly, patients are already being introduced to the topics of genetic testing and counseling, as the American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women receive information regarding carrier screening. The uptake of OCS to evaluate hundreds of disorders is increasing rapidly, with a recent meta-analysis finding that 39% of patients undergo such testing. Currently, however, most cancer-associated mutations are not included in OCS assays. Screening reproductive-age women presents a unique opportunity to perform testing at a time when precancer screening, chemoprevention, and/or risk-reducing surgery is most beneficial.

Limited prior literature suggests that 50-75% of patients would accept combined HCS/OCS if offered. The investigators offered hereditary cancer risk assessment to 100 obstetrical patients in a diverse, Medicaid-predominant Weill Cornell Medicine clinic and found that 66% of patients were interested in cancer risk assessment during pregnancy. Furthermore, the investigators recently published a cost-effectiveness analysis suggesting that incorporation of BRCA1 genetic testing to all patients, regardless of family history at the time of OCS, is a cost-effective management strategy that can result in the prevention of breast and ovarian cancer cases and cancer deaths. Additionally, patient interviews suggest that more than 50% of patients mistakenly believed their OCS included cancer genes. This misconception poses a significant risk, as these patients assume that they had comprehensive testing and no hereditary cancer risk. Therefore, additional testing was believed to be unnecessary. Finally, prior theoretical patient surveys suggest high levels of interest in this combination testing among ethnically diverse populations. However, there has yet to be a prospective study offering patients the combined HCS/OCS, and all reported interests remain theoretical.

Conditions

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Hereditary Cancer Syndromes

Keywords

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Genetic Testing Carrier Screening Prenatal Screening Reproductive Genetic Testing Feasibility Study Universal Screening

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The investigators are offering hereditary cancer screening genetic test to patients already receiving standard of care obstetric carrier screening.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Collection of HCS and OCS for patients receiving obstetrical-related care

The first arm is for an obstetrical/prenatal (standard arm) setting

Group Type EXPERIMENTAL

MyRisk Hereditary Cancer Test

Intervention Type GENETIC

Subjects that are planning to proceed with OCS and enrolled in the trial will be contacted by the genetics clinician (by telephone or in person, based on subject preference) to review the option for HCS in addition to OCS. The WCM genetics clinician will review the potential risks and benefits, possible findings, and implications of findings for HCS. The genetics clinician will follow WCM standards (outlined by the WCM Genetics and Personalized Cancer Prevention Program https://wcinyp.org/GPCP) for informed consent counseling on the potential risks/benefits of HCS. The counseling regarding OCS will have already been performed by the obstetrical team as part of the standard of care. The genetics clinician will review that OCS is being performed as part of the patient's standard of care prenatal visit and HCS is an additional component that is being performed as part of participation in this clinical trial.

Collection of HCS and OCS for patients receiving preconception/fertility care

This second arm is at reproductive endocrinology and infertility clinics (preconception arm)

Group Type EXPERIMENTAL

MyRisk Hereditary Cancer Test

Intervention Type GENETIC

Subjects that are planning to proceed with OCS and enrolled in the trial will be contacted by the genetics clinician (by telephone or in person, based on subject preference) to review the option for HCS in addition to OCS. The WCM genetics clinician will review the potential risks and benefits, possible findings, and implications of findings for HCS. The genetics clinician will follow WCM standards (outlined by the WCM Genetics and Personalized Cancer Prevention Program https://wcinyp.org/GPCP) for informed consent counseling on the potential risks/benefits of HCS. The counseling regarding OCS will have already been performed by the obstetrical team as part of the standard of care. The genetics clinician will review that OCS is being performed as part of the patient's standard of care prenatal visit and HCS is an additional component that is being performed as part of participation in this clinical trial.

Interventions

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MyRisk Hereditary Cancer Test

Subjects that are planning to proceed with OCS and enrolled in the trial will be contacted by the genetics clinician (by telephone or in person, based on subject preference) to review the option for HCS in addition to OCS. The WCM genetics clinician will review the potential risks and benefits, possible findings, and implications of findings for HCS. The genetics clinician will follow WCM standards (outlined by the WCM Genetics and Personalized Cancer Prevention Program https://wcinyp.org/GPCP) for informed consent counseling on the potential risks/benefits of HCS. The counseling regarding OCS will have already been performed by the obstetrical team as part of the standard of care. The genetics clinician will review that OCS is being performed as part of the patient's standard of care prenatal visit and HCS is an additional component that is being performed as part of participation in this clinical trial.

Intervention Type GENETIC

Eligibility Criteria

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Inclusion Criteria

* Age 18 years - 55 years
* Pregnant patients receiving obstetrical-related care or receiving preconception/fertility care at a WCM-affiliated enrollment site.
* Patients who have elected to undergo OCS with the WCM-affiliated obstetrics provider
* Patients with prior OCS but planned to repeat OCS are eligible
* Patients can speak and read in English or Spanish

Exclusion Criteria

* Patients who have previously completed a multigene hereditary cancer syndrome panel
* Patients who have a hematologic cancer or hematologic pre-cancer
* Patients who have a history of an autologous bone marrow transplant
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Myriad Genetics, Inc.

INDUSTRY

Sponsor Role collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Melissa Frey, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

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Reproductive Medicine

Brooklyn, New York, United States

Site Status RECRUITING

NewYork-Presbyterian Weill Cornell Medicine

Brooklyn, New York, United States

Site Status NOT_YET_RECRUITING

Reproductive Medicine

New York, New York, United States

Site Status RECRUITING

Weill Cornell Medicine

New York, New York, United States

Site Status RECRUITING

NewYork-Presbyterian Weill Cornell Medicine Queens

Queens, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Steve Lopez, BA

Role: CONTACT

Phone: 9143127488

Email: [email protected]

Ravi Sharaf, MD, MS

Role: CONTACT

Phone: 212-746-4014

Email: [email protected]

Facility Contacts

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Joshua D. Stewart, MD

Role: primary

Denise Howard, MD, MPH

Role: primary

Alexis Melnick, MD

Role: primary

Elise Barrow, MPH

Role: primary

Steve Lopez, BA

Role: backup

Julia Cron, MD, FACOG

Role: primary

References

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Other Identifiers

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25-02028559

Identifier Type: -

Identifier Source: org_study_id