Genomic Testing

At the 2022 ASCO Genitourinary Cancers Symposium, Neal D. Shore, MD, FACS, presented findings of the prospective study, "Hereditary cancer risk assessment in the community urology practice setting."

A recent trial investigated the prognostic value of the 22-gene Decipher genomic classifier in patients with intermediate-risk prostate cancer.

Hong Truong, MD, served as a co-investigator of a recent study that defined selection criteria for patients with upper tract urothelial cancer for Lynch syndrome screening.

The emergence of tumor-agnostic approvals, such as pembrolizumab for MSI-H solid tumors, has increased the significance of genomic profiling in urology, as patients with prostate, bladder, or kidney cancer may benefit from these therapies.

“We found that while the NCCN guideline for Lynch syndrome is highly specific in identifying patients with Lynch syndrome, it missed about 50% of patients with upper tract cancer who had Lynch syndrome,” says Hong Truong, MD.

“This is one of the first large-scale, and by that, I mean a national-based study throughout the United States, with geographical diversity of community-based urology practices that had a pretty sophisticated background of advanced prostate cancer care,” says Neal D. Shore, MD, FACS.

A study presented at the 2022 ASCO Genitourinary Cancers Symposium investigated how MTAP deletion is a potentially actionable mutation for developing novel therapies for genitourinary cancers.

A recent study published in Radiotherapy & Oncology, investigates the potential for germline variants to predict long-term toxicity in patient who have received radiation.

“Such findings underscore the need for and importance of molecular testing to inform management along with continued research to establish treatment paradigms with appropriately targeted therapies for patients with prostate cancer,” the authors wrote.

In this installment of the Urology Times' 50th Anniversary Innovation Celebration, Veda N. Giri, MD, highlights the role genetic testing has played in a new era of prostate cancer therapeutics.

"A major innovation impacting urology and oncology is the therapeutic advances based on genetic information," says Veda N. Giri, MD.

“What really needs to be done to show that this works is to look prospectively,” says Amar U. Kishan, MD.

“What we found was a signature that you can apply to patients to find out whether they're at high risk of these moderate or greater urinary side effects in the long term, and it did appear to depend on the type of radiation they were receiving,” says Amar U. Kishan, MD.

“We’re going to review CHEK2-related management guidelines, hereditary cancer implications for males and their families…and the importance of cascade testing,” says Veda N. Giri, MD.

“We wanted to see whether certain variations and these micro-RNA binding sites could be associated with the risk of developing side effects,” says Amar U. Kishan, MD.

Ulka Nitin Vaishampayan, MBBS, discusses the FGFR inhibitor erdafitinib and the importance of genetic/genomic testing in bladder cancer.

Cost was the most commonly reported barrier to genetic testing.

Embracing and understanding new and emerging molecular techniques will improve patient outcomes.

The report provides information on the G84E mutation in the HOXB13 gene, which is linked to a significantly increased risk of developing prostate cancer.

“Our case discussion for January 18 is going to be focused on a patient who initially has biochemically recurrent prostate cancer [and] progresses to metastatic disease,” says Veda N. Giri, MD.

The approval of the first PARP inhibitors for prostate cancer was hailed as the "dawn of the precision medicine era" in the field.

“In non–muscle-invasive bladder cancer, we need more biomarkers, something that can hopefully reduce the frequency of invasive procedures for these patients,” says Kristen Scarpato, MD, MPH.

In this interview, Wesley Yip, MD, discusses the feasibility and validation of genomic profiling of upper tract urothelial carcinoma from urine cytology specimens.

“We really have a pretty good understanding of the genomic landscape at the DNA/RNA level, both in non–muscle-invasive disease and muscle-invasive and metastatic disease,” says Seth P. Lerner, MD, FACS.

"I think that we have seen a lot of updates and advances in advanced prostate cancer generally, one of the biggest of these being PSMA-targeted lutetium," says Alicia K. Morgans, MD, MPH.

“We will also cover options for germline testing—different ways that tests can be ordered, panel options that are available commercially,” says Veda N. Giri, MD.

“I think this is an area that needs to be really personalized to each clinical practice,” says Alicia K. Morgans, MD, MPH.

"Liquid biopsy analysis provides a noninvasive and facile tool for early detection, diagnosis, and recurrence surveillance of urological cancer," writes Jim Lu, MD, PhD.

“Adverse pathology is a clear predictor of long-term outcomes for patients,” says Eric A. Klein, MD.

“[Attendees] will be learning multiple aspects in terms of the genetic evaluation for men with prostate cancer,” says Veda N. Giri, MD.