Genetics question

[StayingOptimistic]

I had a genetic evaluation done at MSK. I don’t know how to interpret the results. I understand that there is one acquired and one inherited type. Does the following results indicate that I had both done please?

Here is the test results:

Summary: no mutations, no copy number alterations, no structural variants detected.

MSK-ACCESS is a plasma cell-free DNA (cfDNA) sequencing assay. The ability to detect somatic mutations from cfDNA depends on the amount of tumor-derived DNA shed into circulation, which varies among different patients and within individual patients during the course of disease. Therefore, negative results should be interpreted with caution.

NO SOMATIC ALTERATIONS DETECTED.

Note: The specimen is not evaluable for MSI status.

do I need to have another genetic tests done?

Thank you for your thoughts

[Tall_Allen]

No, you need no further genetic tests. Cell-free DNA detects DNA that has come from your own cells (germline) as well as those that come from tumors (somatic). As with most men, there is nothing actionable now.

[GP24]

The acquired mutations are called somatic and the inherited mutations are called germline. MSK wrote the MSK-ACCESS test did test for somatic mutations. This would mean that you still have to get a germline test. This is a low cost test but would be required if MSK-ACCESS really tests for somatic mutations only.

ascopubs.org/doi/abs/10.120...

[Cooolone]

Yes, MSKCC's ACCESS Test is a Liquid Biopsy that looks specifically for 129 (+/-) known DNA markers associated with Prostate Cancer. Germline or Somatic mutations...

As opposed to:

MSKCC's IMPACT Study which is a Tumor Biopsy that looks for over 400 (+/-) known DNA markers associated with Prostate Cancer. Germline or Somatic mutations...

Both with the helpful attempt to seek out and identify those mutations that are actionable, and may lend weight to prognosticating your disease.

Disclaimer is caution because Somatic changes can occur due to a variety of influences such as diet, environment, toxins, and even treatments for the cancer itself can cause DNA changes. Ask me how I know this...? Lol

Sometimes it's good to know, for example, you have a germline BRCA mutation. This can allow you to inform others in your family, children, etc, and maybe help initiate early awareness and testing. And it may open the door for access to some approved therapies. But out of the 129 & 400+ known markers, there are only a few drugs available to answer the call, and with limited effect.

Lastly, those drugs sometimes do fall into the FDA (U.S.) approved "application" of, and therefore is reserved for specific staging, ie, usually advanced, before access to them is granted.

Best Regards

[HopingForTheBest1]

A genetic counselor should have been made available to you by MSK. to answer your questions.