Genomic Testing

“What we really want to do is have more enhanced engagement of broader populations,” says Veda Giri, MD.

"Given the fact that this field has really expanded, we see that patients are engaging with genetic testing in various different ways," says Veda Giri, MD.

The application is supported by findings from the phase 3 MAGNITUDE study.

“We need to leverage these great platforms to put out high-quality information with experts that people can listen to from home or on the go and get the information that they need,” says Stacy Loeb, MD, MSc.

The GPS test uses a 17-gene signature to predict disease aggressiveness and help guide treatment decisions for patients with localized prostate cancer.

IsoPSA is included in the National Comprehensive Cancer Network Prostate Cancer guidelines for early detection of the disease.

“I think this is a nice cluster of podcasts that really go at this from different angles,” says Stacy Loeb, MD, MSc.

“So many patients with prostate cancer qualify for genetic testing, but it's currently underutilized,” says Stacy Loeb, MD, MSc.

“We don’t want to subject patients to a therapeutic strategy that they are unlikely to benefit from,” says Atish D. Choudhury, MD, PhD.

“It really was a multidisciplinary effort to pull the data together [and] provide the clinical implications [of] the genetic markers,” says Veda N. Giri, MD.

Here is some of the top content on genomic testing from the past year.

Tanya Dorff, MD, explains how the next frontier in mCSPC will be the ability to select patients for treatment based more on molecular stratification and not only on disease volume or metachronous vs synchronous presentation.

The study found pathogenic or likely pathogenic variants in DNA damage repair genes and HOXB13 to be more frequently observed in Black men with a family history of cancer.

UriFind uses a urine sample to assess whether a patient has bladder cancer, avoiding an invasive cystoscopy.

“At this time, there are at least 2 classes of therapeutic agents which are used for patients with certain germline or somatic genetic mutations,” says Emmanuel S. Antonarakis, MD.

HIF-2α inhibitors, such as belzutifan (Welireg), are a promising new class of agents emerging in the renal cell carcinoma treatment paradigm, explains Eric Jonasch, MD.

“Many urologists in large group practices are doing genetic testing, especially for their high-risk patients,” says Emmanuel S. Antonarakis, MD.

“Our study offers molecular and cellular insights into this aggressive subtype of prostate cancer, which we hope will ultimately impact patient care,” said the study’s lead author, Hong Yuen Wong, PhD.

“Prostate cancer is…a BRCA-linked cancer, so we can increase the messaging surrounding prostate cancer on social media platforms, we can increase the amount of awareness on the genetic link that exists with prostate cancer, so that patients are also more empowered to bring this up with their providers,” says Sameer Thakker, MD.

“The other aspect of this study that really fascinated us was how patients are getting information about cancer genetic testing,” says Sameer Thakker, MD.

All patients with prostate cancer, except for those with low-risk or very low-risk localized disease, should be tested for germline mutations, and somatic testing should be done in all patients with metastatic disease as there are therapeutic implications, according to Emmanuel S. Antonarakis, MD.

A higher score on PORTOS, an expression signature of 24 DNA damage repair and immune pathway genes, predicted improved response to dose-intensified salvage radiotherapy after radical prostatectomy in patients with biochemically recurrent prostate cancer.

"Clinicians now have access to tools that can assist them with turnaround times and report interpretation, thereby aligning with national guidelines on genetic testing,” said Neal Shore, MD.

Researchers hope to find synergistic effects with the combination of the ribosomal RNA synthesis inhibitor pidnarulex and the PARP inhibitor talazoparib.

Moffitt Cancer Center conducted the first prospective study to investigate genomic biomarkers associated with aggressive disease in African American men with prostate cancer

Research findings suggest that SLIT2 loss in circulating tumor cells promotes metastasis and enhances cancer progression, according to a Northwestern Medicine study published in Science Advances.

The talazoparib/enzalutamide combination was also shown to have benefits in key secondary end points, including prostate specific antigen (PSA) response, time to PSA progression, and overall response rate.

“Men with this type of metastatic prostate cancer want to get their genetically targeted therapy as early as possible, and this trial clearly shows the value of rucaparib as a treatment for these men,” said Alan H. Bryce, MD, principal investigator of the TRITON3 trial.

Cell-free DNA–based next-generation sequencing profiling resulted in low detection/concordance in clear cell renal cell carcinoma.

“There’s a tremendous amount of work going on right now with PARP inhibitors in the resistant stage, but now also we’re looking at them in the sensitive stage,” says Neal D. Shore, MD.