Liquid Biopsy and Somatic Genetic tests

[Christopherg]

Happy New Year and good health to you all.

I would be very grateful for advise on 2 questions:

When is the best time to do:

1) the somatic genetic test?

2) have a liquid biopsy?

I am on my 3rd ADT drug treatment (Lupron & Cassodex).

My oncologist says I am heading towards castrate resistance.

Thank you for your opinions and any advise is appreciated.

Chris

[Tall_Allen]

Your best bet is to sign up for a clinical trial that tests for somatic mutations (by either method). There are only two types of mutations for prostate cancer that currently have an approved treatment (platins for neuroendocrine and Keytruda for MSI-H/dMMR). There are clinical trials for others, including PARP inhibitors. Somatic mutations accumulate over time, so a drug that is ineffectual now may become effectual later. Cell-free DNA now available with "liquid biopsies" have the advantage in accumulating DNA from all metastases, whereas tumor biopsies are only specific to that tumor that was biopsied. It's very expensive.

[Christopherg in reply to Tall_Allen]

Good morning Allen,

In your opinion, should I have the somatic and liquid biopsy done now?

I am still marginally hormone sensitive though my oncologist says I am heading towards castrate resistance.

Your thoughts are appreciated.

Chris

[Tall_Allen in reply to Christopherg]

They are expensive outside of clinical trials and with time there may be more medicines that are effective.

[Christopherg in reply to Tall_Allen]

Thank you so much Allen,

I will research the clinical trials suggestion.

Sincere appreciation for your guidance and concern.

Chris