Dr. Shore on genetic alteration studies in prostate cancer

Commentary
Video

“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.

In this video, Neal D. Shore, MD, FACS, discusses the take-home message from the study, “Influencing Best Practices for Genomic and Germline Testing in Urology,” for which he served as the lead author. Shore is the medical director of Carolina Urologic Research Center in Myrtle Beach, SC, and the chief medical officer for urology and surgical oncology at GenesisCare.

Video Transcript:

The rhetorical question is it’s not if you're going to start testing, it's when are you going to start testing? Because we now have a clinical utility for patients who have homologous recombinant repair alterations, most commonly known one would be BRCA2, but there are others within that gene panel that would indicate a patient for consideration of PARP inhibitor therapy in mCRPC, possibly with combination. There are multiple studies ongoing looking at HRR mutation population patients in the mHSPC population. If you find [microsatellite instability] MSI high, [tumor mutational burden] TMB high, in 3% of patients in mCRPC, yes, it's small, but it's a eureka moment because there's a tumor agnostic indication for being able to use pembrolizumab. And then of course, specific trials, looking at certain gene alterations. A notable one is ATM. We have certain ATM trials specific just for the ATM alteration because that tends to be a very aggressive biology. 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. It's not going to be only in prostate cancer, but we're already starting to see this in bladder cancer and kidney cancer as well.

This transcription has been edited for clarity.

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