Evidence map›Paper›PMID 40240123›Full record

ArticleInternational journal of cancer2025

Nationwide implementation and evaluation of the Tumor-First workflow for genetic testing in ovarian carcinoma.

Vera M Witjes, Joanne A de Hullu, Dorien M A Hermkens, Yvonne H C M Smolders, Julie E M Swillens, Sarah-Lotte Slob, Tjalling Bosse, Marian J E Mourits, Margreet G E M Ausems, Tumor‐First Implementation Group and 2 more

Abstract read
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In one paragraph

Article in International journal of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Evaluation of homologous recombination testing in ovarian carcinoma.Virchows Archiv : an international journal of pathology · 2026
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Vera M WitjesDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-0684-3071
Joanne A de HulluResearch Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0001-5578-092X
Dorien M A HermkensDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
Yvonne H C M SmoldersDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
Julie E M SwillensResearch Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0001-9337-1318
Sarah-Lotte SlobDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
Tjalling BosseDepartment of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Marian J E MouritsDepartment of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Margreet G E M AusemsDivision Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.
Tumor‐First Implementation Group
Marjolijn J L LigtenbergDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0003-1290-1474
Nicoline HoogerbruggeDepartment of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.

Funding

KWF Kankerbestrijding 12732
6 · The paper itself

Abstract

Despite international agreement on the importance of tumor DNA testing and germline testing for determining PARP inhibitor treatment eligibility in patients with ovarian carcinoma (OC) and for cancer prevention in their relatives, the optimal strategy remains under debate. In the Netherlands, the "Tumor-First workflow" was initiated and implemented nationwide: a well-validated tumor DNA test is the primary test for detecting tumor pathogenic variants (PVs) in OC risk genes (BRCA1/2, RAD51C/D, BRIP1, PALB2). The detection of tumor PVs is subsequently used to stratify germline testing and determine treatment eligibility. The Tumor-First workflow is efficient and saves costs. The aim of this study was to evaluate the nationwide implementation of the Tumor-First workflow. We analyzed real-time genetic testing practices, including tumor DNA and germline testing, in patients diagnosed with OC from 2019 to 2023, as identified through the Dutch Pathology Registry (Palga). Testing data were collected from diagnostic pathology and genetic reports. Out of the 3926 OC patients, 2778 (71%) received OC tumor DNA testing as the primary test. Between 2019 and 2023, this percentage increased from 50% to 85%. Of these tumor DNA tests, 2703 (97%) were successful, with 398 (15%) resulting in the identification of a PV in an OC risk gene. Most of these patients (291; 73%) underwent germline testing, and 147 (51%) were found to have a germline PV. We conclude that the nationwide implementation of the Tumor-First workflow for OC was effective. Multidisciplinary efforts contributed to a more efficient detection of germline and somatic PVs in OC risk genes.

Indexed as

Genetic TestingOvarian NeoplasmsAdultAgedBRCA1 ProteinBRCA2 ProteinFanconi Anemia Complementation Group N ProteinFanconi Anemia Complementation Group ProteinsFemaleGenetic Predisposition to DiseaseGerm-Line MutationHumansMiddle AgedNetherlandsPoly(ADP-ribose) Polymerase InhibitorsRNA HelicasesBRCA1 ProteinBRCA1 protein, humanBRCA2 ProteinBRCA2 protein, humanBRIP1 protein, humanFanconi Anemia Complementation Group N ProteinFanconi Anemia Complementation Group ProteinsPALB2 protein, humanPoly(ADP-ribose) Polymerase InhibitorsRNA HelicasesBRCAepithelial ovarian cancerimplementationneoplasm DNAworkflow

Identifiers

PMID40240123
PMCPMC12141975

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.