While not a lot of specific focus on PCa (Like at the GU ASCO Meeting earlier this year), this full-access section from their Educational Book released at this week's ASCO Annual Meeting in Chicago may be of interest to those here who want to understand the oncology community's current view on precision medicine for PCa. It includes a good summary update on PSMA for diagnostics and therapy.
Here is a link to the ASCO 2024 Session Outline:
meetings.asco.org/2024-asco...
and the educational book section (free access) referenced in the post title:
ascopubs.org/doi/10.1200/ED...
From the ASCO book:
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Why Precision Medicine in PCa?
PCa is a very heterogeneous disorder, and much of this variability has been linked to the genetic background of the disease.3-5 The Norwegian Twin Cancer study found that up to 57% of PCa risk is attributable to genetic factors that are largely inherited.6,7 Germline sequencing performed on nearly 700 patients with metastatic PCa found that 11.8% had germline mutations in genes associated with DNA repair.8 Another study of men with mCRPC identified targetable mutations in 19.3% of patients, and approximately half of these mutations were inherited.9 The prevalence in patients with nonmetastatic high-risk PCa is also >5%.10,11 On the basis of these findings, the National Comprehensive Cancer Network (NCCN) guidelines and others recommend patients with metastatic, or high- or very high-risk localized disease undergo germline genetic testing. These guidelines also recommend that patients with metastatic disease undergo somatic genetic testing. Testing for BRCA1/2, PALB2, CDK12, CHEK2, MSH2, and MSH6 should be prioritized. This information is critical, as the identification of these mutations may change treatment plans. In addition, other variants may help identify aggressive variant PCa or other markers of prognosis.12,13 Thus, genetic testing has become an important component of the management of patients with PCa. (emphasis added)
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The Norwegian Twin #s were a big surprise to me - and I wonder if they are applicable outside of the Norwegian gene pool? One of the issue for testing is the use of tissue from an old biopsy (should be OK for germline) vs liquid biopsy using a current blood sample (better for catching somatic mutations.) Dr. Alicia Morgans discussed this briefly in the PeterMac GUcast podcast linked in an earlier post.
Ciao - cujoe
