New study identifies barriers limiting access to precision treatment for ovarian cancer patients

For patients advanced ovarian cancer, a simple biomarker test can help determine whether they are likely to benefit from a targeted therapy and avoid unnecessary side effects. Yet despite its proven clinical value, access to homologous recombination deficiency (HRD) testing remains inconsistent across Canada and around the world.

A new study led by researchers at BC Cancer explores why. Funded through a Marathon of Hope Cancer Centres Network’s Patient Voices in Research Award, the study reviewed over a dozen academic publications to identify the key barriers preventing wider adoption of HRD testing, while offering practical recommendations to help bring these precision oncology tests into routine cancer care.

“HRD testing helps identify patients who are most likely to benefit from a class of targeted drugs known as PARP inhibitors,” explains Dr. Helen McTaggart-Cowan, team lead and Senior Scientist at BC Cancer. “These therapies can significantly improve outcomes for some patients, but they are not effective for everyone and can cause serious side effects. Testing allows clinicians to better match treatment to each patient's reality and their personal preferences, ensuring therapies are used where they are most likely to make a difference.”

The paper reviewed 16 published studies examining the perspectives of both healthcare providers and patients. The review found broad agreement that HRD testing is an important part of personalized cancer care. However, they also identified that inconsistent funding, limited awareness about its existence among both patients and healthcare providers, long turnaround times, varying clinical guidelines, and unequal access to testing across healthcare systems, is hindering the potential use of these tests.

"The science supporting HRD testing is strong, but many patients still face barriers to accessing it," said Dr. McTaggart-Cowan. "Our review shows that improving education, standardizing clinical practices and expanding access to testing are essential steps toward ensuring more patients can receive personalized therapies with PARP inhibitors."

The work aligns closely with the MOHCCN's mission to understand and helping to remove the barriers that exists in making precision oncology available to all Canadians. It also reflects the Network’s commitment to funding patient-centric research and care, with funding for this project coming from the Patient Voices in Research Initiative, which supports research selected by patients for patients.

"Our goal isn't simply to develop new precision medicine tools—it is to make sure that they reflect the needs and wants of patients so that they can actually benefit from them," said Dr. McTaggart-Cowan. "By understanding the challenges patients and healthcare providers face, we can help build a more equitable cancer care system where biomarker testing becomes a routine part of care rather than an exception."

Study:

Applying the health belief model to explore healthcare provider and patient perspectives on homologous recombination deficiency testing in cancer: A narrative review

Authors:

Dohyun Kevin Kim, Mashiad Mostafa, Yelena Aizenberg, Melica Nourmoussavi Brodeur, Mark S. Carey, Sarah E. Ferguson, Laura Hopkins, Iwa Kong, Janice S. Kwon, Susie Lau, Donna Pepin, Karla Willows, Christa Wood, Helen McTaggart-Cowan

Funding:

The study was funded through the Marathon of Hope Cancer Centres Network Patient Voices in Research Initiative, a first-of-its-kind program in Canada that supports patient-directed research to improve precision oncology for Canadians living with cancer. Read more about Dr. McTaggart-Cowan’s project, here.