Genomic Testing

“It’s exciting that now in 2023 we have 3 FDA-approved PARP inhibitors for the treatment of our prostate cancer patients,” says Joshi Alumkal, MD.

Joshi Alumkal, MD, discusses the phase 3 TALAPRO-2 trial, which supported the FDA approval of the combination of talazoparib and enzalutamide for patients with metastatic castration-resistant prostate cancer whose tumors harbor homologous recombination repair gene defects.

The approval of the olaparib/abiraterone regimen was based on an exploratory subgroup analysis of the phase 3 PROpel trial consisting of the 85 patients in the study with BRCA-positive metastatic castration-resistant prostate cancer.

Approximately half of prostate cancer patients with clinically actionable gene variants do not meet the NCCN guideline criteria for genetic testing, according to findings from the PROCLAIM trial.

The FoundationOne CDx test will identify patients who are eligible to receive niraparib plus abiraterone based on the genomic profile of their prostate tumor.

The approval of the niraparib/abiraterone dual-action tablet for BRCA-positive mCRPC is based on findings from the phase 3 MAGNITUDE study.

“We are now doing more testing on the RNA side,” says Brittany M. Szymaniak, PhD, CGC.

The study assessed US veterans receiving care at the Veterans Health Administration for all cancer types, including prostate cancer.

Patients classified as GC high risk had a 5-year disease progression of 40%, compared with 20% among GC low-risk patients.

This marks the first worldwide approval for the niraparib/abiraterone dual-action tablet.

The investigators identified several genetic factors, including ARID1A mutation, that correlated with survival outcomes in patients with advanced urothelial carcinoma treated with immune checkpoint blockade.

"In our sample, nearly 10% of patients [with prostate cancer] had a gene variant that made them eligible for effective new therapies, with faster results than traditional referral for genetic testing and counseling,” said Maria I. Carlo, MD.

Michael S. Leapman, MD, MHS, highlights a study of patient experiences with tissue-based genomic testing during active surveillance for prostate cancer.

Researchers identified 9 novel susceptibility loci for prostate cancer, 7 of which were substantially more prevalent in patients of African ancestry.

“Vanderbilt researchers are participating in numerous projects related to PRS and disease risk; studies such as this highlight the importance of evaluating whether novel clinical tools actually enhance care,” said Kerry Schaffer, MD.

There currently 2 PARP inhibitors—olaparib and rucaparib—approved as monotherapies for the treatment of patients with metastatic castration-resistant prostate cancer.

“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.