Grant Number:	1R01CA308143-01A1 Interpret this number
Primary Investigator:	Rauh-Hain, Jose
Organization:	University Of Tx Md Anderson Can Ctr
Project Title:	Ignite-TX
Fiscal Year:	2026

Hereditary cancer syndromes, such as hereditary breast and ovarian cancer (HBOC) and Lynch syndrome (LS), account for approximately 15% of cancers and pose a significant public health challenge. Although proactive identification through cascade genetic testing (CGT) offers opportunities to mitigate cancer risk, only 10-20% of individuals with HBOC and 2% with LS have been identified in the U.S. Current CGT practices rely on probands (affected individuals) to inform at-risk relatives (ARRs), resulting in suboptimal ARR testing rates due to financial, logistical, and structural barriers. The primary objective of IGNITE-TX (Identifying Individuals for Genetic Testing & Treatment) is to evaluate the effectiveness of an intervention designed to increase CGT uptake among populations with limited access to hereditary cancer services. Aim 1 assesses the impact of IGNITE-TX on CGT uptake at six months, comparing intervention arms with and without the provision of free genetic counseling and testing. Aim 2 evaluates the intervention's effect on key short-term outcomes, including improvements in genetic knowledge, self-efficacy, family communication, and reductions in distress, using a mixed-methods approach. Aim 3 employs formative and process evaluations guided by the RE-AIM QuEST framework to optimize implementation and dissemination of IGNITE-TX, ensuring scalability and sustainability across low-resource and safety-net settings. IGNITE-TX employs family genetic navigators and web-based educational tools to increase CGT uptake and enhance hereditary cancer prevention. The study will recruit 700 probands and 1,400 ARRs nationwide. Using a randomized hybrid type I effectiveness-implementation trial, probands and their families will be assigned to one of four groups: 1) Usual care; 2) Free genetic counseling and testing; 3) IGNITE-TX; and 4) IGNITE-TX plus free genetic counseling and testing. IGNITE-TX offers a scalable, patient-centered model to improve CGT uptake through education, family communication, and navigation support, facilitating informed decision-making and access to genetic services. The results will inform public health strategies and support broader implementation of CGT in populations with limited access to genetic services, advancing precision prevention for hereditary cancers. This study aligns with NCI priorities for cancer prevention and early detection and addresses critical gaps in CGT research.





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