Genomic Testing

The miR Sentinel molecular test uses a biostatistical algorithm to examine small noncoding RNAs isolated from urinary exosomes and determine an individual’s risk of aggressive prostate cancer.

The Centers for Medicare and Medicaid Services is covering the Signatera molecular residual disease test for use in patients with muscle-invasive bladder cancer.

In this interview, Simpa Salami, MD, MPH, discusses the development of urinary biomarkers in prostate cancer detection.

In a recent study, investigators administered a small-molecule inhibitor called MYCi975 to prostate cancer cells, examining the effects on gene expression throughout the human genome.

Robert E. Brannigan, MD, discusses which men with infertility issues should receive genetic testing.

Rao is an investigator on the ongoing phase 3 CASPAR trial exploring the AR pathway inhibitor enzalutamide combined with the PARP inhibitor rucaparib in patients with mCRPC.

Fear of discrimination has downstream effects on health care.

TROP-2 and Nectin-4, surface cell targets of sacituzumab govitecan and enfortumab vedotin, respectively, are highly expressed in variant histology bladder cancer.

“We really try to be careful about testing, especially when it's a potential burden of costs on the patient. What we really look at is where it's going to have an impact,” says Stephen J. Savage, MD.

The study specifically examined this precision medicine pathway in the context of frontline treatment selection between nivolumab with or without ipilimumab and a VEGFR tyrosine kinase inhibitor.

High genomic loss of heterozygosity may serve as a predictive marker for response to talazoparib in patients with metastatic castration-resistant prostate cancer.

Results shared during the 2022 AACR Annual Meeting suggested that genetic adjustment of prostate-specific antigen may reduce overdiagnosis of prostate cancer, de-escalate invasive testing, and improve the detection of aggressive disease.

NGS empowers clinicians to take proactive measures to prevent disease, enables more precise diagnosis, and provides better insight on the best treatment option.

The applications for germline and somatic genetic testing in prostate cancer have skyrocketed, carving out an important role in screening, diagnosis, and treatment.

“The take-home message is that it's not a question of if you're going to start doing a hereditary cancer risk assessment, it's when,” says Neal D. Shore, MD, FACS.

“I think that it's very clear that this test is independently prognostic,” says Daniel E. Spratt, MD.

“The traction on this, I think, is really rather remarkable,” says Neal D. Shore, MD, FACS.

“I think one important message here is that MTAP is an important novel pathway in carcinogenesis, particularly bladder and urothelial carcinomas,” says Philippe E. Spiess, MD, MS, FRCSC, FACS.

“The management of hereditary upper tract cancer and Lynch syndrome [is] a multidisciplinary approach,” says Hong Truong, MD.

“We need to look at tumors a little bit differently. Not so much put them in the same categories, but really look at them based on whether the mutation is as identified in that specific marker,” says Philippe E. Spiess, MD, MS, FRCSC, FACS.

“I think that [these findings] definitely [warrant] standard of care radiation and hormone therapy for these patients or other forms of radical therapy,” says Daniel E. Spratt, MD.

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.