Kathryn Gessner, MD, discusses her use of genomic testing in clinical practice

Genomic testing is enabling clinicians to personalize treatment plans based on individual patient and tumor characteristics. In a recent interview with Urology Times®, Kathryn H. Gessner, MD, PhD, outlines the clinical scenarios in which she finds genomic testing most useful.

Gessner is an assistant professor of urology at the University of North Carolina School of Medicine in Chapel Hill.

“The clinical situation in which I use it the most is when there's uncertainty or discrepancy between clinical and pathologic characteristics, such as if there's a Gleason 3+3 prostate cancer, but a high [prostate-specific antigen level],” Gessner explained.

However, she cautions that she uses these tests as an adjunct to other clinical information in order to make decisions on next steps.

“I don't typically determine the next steps or recommend treatment solely based on that test; I use it in addition to the clinical or pathologic variables,” she noted. “So, for example, in that in that previous situation, if there is a high Decipher score, I don't necessarily proceed immediately with treatment, but I may recommend that the patient undergo a confirmatory biopsy sooner.”

Gessner also detailed other uses for genomic testing across other genitourinary malignancies, such as using ctDNA or urine-based biomarkers in bladder cancer or using gene-based panels to identify hereditary syndromes such as Von Hippel-Lindau disease in patients with kidney cancer.