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Study examines molecular alterations in intraductal carcinoma of the prostate


“We found some BRCA1 and BRCA2 mutations, as well as CDK12 mutations, in our cohort of patients with intraductal carcinoma of the prostate. Those are things that you could use now for clinical decision-making with PARP inhibitors with their approved indications,” says Benjamin Miron, MD.

In this video Benjamin Miron, MD, a medical oncologist at Fox Chase Cancer Center, discusses the background and findings of a study he presented at the 2023 ASCO Annual Meeting entitled, “Clinical implications of molecular alterations in intraductal carcinoma of the prostate.”1


Because of what we know about the clinical phenotype, we wanted to learn more about the molecular landscape and some of the drivers of what might be different about intraductal carcinoma. So we worked with Caris Life Sciences to look into their database of thousands and thousands of samples, and specifically, we took prostatectomy specimens and identified those that had intraductal carcinoma, and did sequencing and looked at the sequencing data from those.

In the study, we had about 31 cases that we identified. Because it's a relatively new addition to the diagnostic criteria, we have to go through and try to identify more cases. But in those 31 cases, we know that they're all men because they’re prostate cancer specimens, and there was a very large predominance of high grade group disease—84% out of the whole cohort was Grade Group 5. So that fit with what we what we think we know about intraductal prostate cancer.

At the 2023 ASCO Annual Meeting, we presented the molecular landscape of intraductal carcinoma. We saw that there were a number of different alterations that are interesting, but a few that are actually clinically actionable. We found some BRCA1 and BRCA2 mutations in the cohort, as well as CDK12 mutations. Those are things that you could use now for clinical decision making with PARP inhibitors with their approved indications.

What we also did was another analysis where we compared the intraductal cases from our cohort to a different published study for localized prostate cancer and metastatic castrate-sensitive prostate cancer. And visually, when you look at the 2 distributions—and you're trying to compare the distribution mutations—the intraductal prostate cancer was much more similar to metastatic disease than it was to the other localized disease cohort. And I thought that was interesting based on the risk of metastasis with this entity.

Transcript has been edited for clarity.


1. Miron B, Wei S, Yasmine B, et al. Clinical implications of molecular alterations in intraductal carcinoma of the prostate. J Clin Oncol 41, no. 16_suppl (June 01, 2023) 5024-5024. doi: 10.1200/JCO.2023.41.16_suppl.5024

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