Genomic Testing

“So, my take home message for the urology community is even if you're not doing clinical trials, we already have FDA-approved, CMS-covered, most commercial insurances-covered genetic alterations now for our CRPC populations, and there will be more to come,” says Neal D. Shore, MD, FACS.

"Our studies consistently demonstrated that data from the Decipher Prostate Genomic Classifier was more reliably predictive of prostate cancer progression and underlying pathology than any other clinical data available, including MRI," says Eric Kim, MD.

Correlation found between the biomarker HSD3B1 and resistance to combined hormone therapy and radiotherapy

"The genomics assay was using biopsy tissue to help patients make decisions for the treatment choices. We also tested the effect of the assay on provider choice," says Adam B. Murphy, MD, MBA, MSCI.

“Our analysis suggests that there is superior clinical benefit with olaparib versus control both in patients who had and had not received previous taxane treatment,” said Maha Hussain, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

"Then [we] also started looking at somatic testing, because if you only stop at germline testing, you miss another 50% of patients who would have somatic alterations who have resistant prostate cancer," says Neal D. Shore, MD, FACS.

"In these studies, we were pleased to find that disitamab vedotin has consistent efficacy and manageable safety in patients with chemotherapy-refractory mUC," says Jun Guo, MD.

A recently published study found an association between PARP inhibitor treatment and an increased risk of hematological adverse events, including anemia, thrombocytopenia, and neutropenia, in patients with metastatic castration-resistant prostate cancer.

On an episode of Cleveland Clinic’s Cancer Advances podcast, host Dale Shepard, MD, PhD, talks with Omar Mian, MD, PhD, about emerging molecular biomarkers for genitourinary cancers.

According to the survey, 79% of Black men know that genetic information can help improve prostate cancer outcomes, yet 33% indicated that they would be unwilling or uncertain to provide DNA samples, even if it meant finding new treatment options.

Circulating tumor DNA is showing promise as a tool to guide decisions on treatment intensification and de-escalation in patients with renal cell carcinoma.

Translocation renal cell carcinoma is a rare type of RCC that is typically characterized by gene fusions involving the MiT family of transcription factors including TFE3, TFEB, TFEC, and MiTF.

Notably, the study represents a 57% increase in the number of non-European participants compared with previous prostate cancer genome-wide association studies.

"For those people in the intervention arm who did get the assay, the doctors were more likely to prefer active treatment with surgery or radiation compared to the control group," says Adam B. Murphy, MD, MBA, MSCI.

"All of our tools, including genomics and MRI, enable us to do a better job of risk stratifying [patients] to have a more appropriate shared decision-making discussion [about active surveillance]," explains David Morris, MD.

"ctDNA holds a unique position as it offers a molecular means to quantify the extent of residual disease burden," says Adanma Ayanambakkam, MD.

In a recent interview, Rohan Garje, MD, chief of genitourinary oncology at the Miami Cancer Institute, discussed the evolving paradigm with PARP inhibitors in prostate cancer.

“This is the first study in upper tract urothelial carcinoma to show that ctDNA may be used to refine clinical staging and prognosis in these patients prior to surgery,” says Heather L. Huelster, MD.

"In this study, we sought to evaluate the utility of a non-invasive biomarker—ctDNA—in predicting muscle-invasive and non–organ-confined staging of upper tract urothelial carcinoma," says Heather L. Huelster, MD.

The model may help identify patients with urothelial carcinoma who could benefit from PPARG inhibition through FX-909, a first-in-class small molecule inhibitor of PPARG.

“Our results provide molecular insights for potential therapeutic strategies to treat prostate cancer and other AR-involved diseases by targeting AR multivalent interactions,” said Zhijie “Jason” Liu, PhD.

"These tests, germline and tumor somatic testing, are extremely important and can no longer be ignored in the clinic when we see these patients," says Neeraj Agarwal, MD.

Alexandra Sokolova, MD, explains the importance of genetic testing for patients with high-risk localized and advanced prostate cancer, as well as for their high-risk family members.

The Invitae Common Hereditary Cancers Panel utilizes DNA taken from a blood sample to identify the presence of variants in 47 genes linked to an increased risk of developing certain cancers.