Integration of family history, germline genetics is important in defining prognosis of prostate cancer

In this video, Keyan Salari, MD, PhD, describes the implications for screening and decision making in prostate cancer from the recent Journal of Urology study “Impact of Family History and Germline Genetic Risk Single Nucleotide Polymorphisms on Long-Term Outcomes of Favorable-Risk Prostate Cancer.” Salari is a urologic oncologist at the Massachusetts General Hospital and Harvard Medical School.

Transcription:

What implications do these findings have for screening and decision making in prostate cancer?

I think the greatest implication the study has is that it tells us that family history and germline genetics independently provide complementary information that's important for risk stratification of localized prostate cancer. Further validation of these findings is definitely warranted, including how rare pathogenic mutations like BRCA1 or BRCA2 mutations, which were not assessed in the study, interact with these more common risk SNPs and family history. I'd also like to acknowledge that the study's cohort was a predominantly White population of European ancestry, and that limits the generalizability to other studies such as Black or African ancestry populations who we know carry a greater than two fold risk of dying of prostate cancer. That just underscores how critically important it is to include diverse populations in future studies.

What is the take-home message for the practicing urologist?

I would say the take-home message is that integration of family history and germline genetic testing is an important component of defining the prognosis of patients with newly diagnosed localized prostate cancer. And in this era of precision oncology, individualizing our treatment approach should take this type of information into account.

This transcription was edited for clarity.