Advertisement


Neal D. Shore, MD, on Germline Genetic Testing and Its Impact on Prostate Cancer Clinical Decision-Making

2022 ASCO Annual Meeting

Advertisement

Neal D. Shore, MD, of the Carolina Urologic Research Center, discusses his study findings, showing that germline genetic testing influenced care for patients with prostate cancer. Men whose genetic test was positive for a pathogenic germline variant received more recommendations for changes to follow-up and treatment, and for testing and counseling of relatives, than did patients with negative or uncertain test results (Abstract 10500).

 



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
1,000 patients, prospectively analyzed for pathogenic variations via germline testing. That's what we did, 15 US urology sites, combining both community and academic sites. We presented our findings at ASCO 2021. At that point we revealed, in an oral podium presentation, that 50% of the PGVs, the pathogenic variants of germline, were within NCCN criteria and 50% were outside NCCN criteria. At ASCO 2022, we're presenting now the clinical considerations. What did our colleagues do with this information? Again, of note, 50% of the patients who received germline testing, would've fallen outside of NCCN criteria. This is important because we're really trying to democratize, and open up, germline testing to anyone with a diagnosis of prostate cancer. In our study, it included patients who had metastatic disease, biochemical relapse, newly diagnosed, prostate cancer. Furthermore, of our 1000 patients, 21% identified as nonwhite, so we had a very significant Black and Latino population. I think this is incredibly important given the ongoing themes of inclusion, equity, and disparity, which ASCO is promoting. Of note of our patients, 10% had pathogenic variants. Interestingly, it was around a discordance of 12% white and 4% in the black population, despite the 80-20% prevalence that we obtained. Now, interestingly, we had a two thirds higher number of patients in the black population who had alterations, gene alterations, of uncertain variations, or VUSs. This, I think, speaks to the fact that we've normalized VUS in a much greater way for the white population, not just in the US, but globally. Regarding the clinical considerations, our colleagues utilized clinical trials when there were PGVs that were found positive. The top five PGVs of the five, four out of the five were in DDR alterations. As we all know, we have PARP inhibitors and other findings that are actionable, certainly in the US, there's an FDA approval for PARP inhibition. Then another significant amount of patients went on to clinical trials. Remarkably and profoundly, more than two thirds of patients ultimately received referral to certified genetic counselors, or some form of genetic counseling, via telehealth, or from the sites themselves. There are certain limitations to our study in that it was a one shot time assessment. We are looking at longitudinal assessments. These were in urology community practices. It may be different at academic medical oncology sites, but what's important to note is that this had a very favorable, when we looked at questionnaires from the sites that participated, that they felt us, it was not only implementable, actionable, but also of great value for them as well as in the patient physician shared decision making.

Related Videos

Breast Cancer
Immunotherapy

Ann H. Partridge, MD, MPH, and Ian E. Krop, MD, PhD, on Metastatic Breast Cancer: New Early Data on Patritumab Deruxtecan

Ann H. Partridge, MD, MPH, Dana-Farber Cancer Institute, and Ian E. Krop, MD, PhD, of Yale Cancer Center, discuss phase I/II findings on patritumab deruxtecan, a HER3-directed antibody-drug conjugate, in patients with HER3-expressing metastatic breast cancer. A pooled analysis showed antitumor activity in women with HR-positive/HER2-negative and HER2-positive advanced disease, as well as triple-negative breast cancer (Abstract 1002).

Colorectal Cancer
Genomics/Genetics

Michael J. Overman, MD, and Smitha Krishnamurthi, MD, on RAS Wild-Type Metastatic Colorectal Cancer: Refining Treatment Strategy

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Smitha Krishnamurthi, MD, of the Cleveland Clinic, review three abstracts, all of which enrolled patients with newly diagnosed RAS and BRAF wild-type metastatic colorectal cancer with left-sided primary tumors. The discussion centers on what the study results indicate about the use of an EGFR therapy and weighing the risk to quality of life from rash, in particular (Abstracts LBA3503, LBA3504, LBA3505).

Pancreatic Cancer

Pamela L. Kunz, MD, on Pancreatic Neuroendocrine Tumors: A Final Analysis of Temozolomide or Temozolomide Plus Capecitabine

Pamela L. Kunz, MD, of the Yale University School of Medicine, discusses new findings from the ECOG-ACRIN E2211 trial, which showed the longest progression-free survival and highest response rates with temozolomide plus capecitabine reported to date for patients with pancreatic neuroendocrine tumors. The presence of a deficiency of MGMT, the drug-resistance gene, was associated with greater odds of an objective response (Abstract 4004).

Skin Cancer

Georgina V. Long, MD, PhD, on Melanoma: New Data on Pembrolizumab, Dabrafenib, and Trametinib

Georgina V. Long, MD, PhD, of the Melanoma Institute Australia, The University of Sydney, discusses findings from the NeoTrio trial on neoadjuvant pembrolizumab alone, in sequence with, or concurrent with dabrafenib plus trametinib in patients with resectable BRAF-mutant stage III melanoma. The study may help clinicians determine the optimal combination of therapy (Abstract 9503).

Breast Cancer

Tara B. Sanft, MD, on How Diet and Exercise May Affect Completion of Chemotherapy for Breast Cancer

Tara B. Sanft, MD, of Yale University, discusses the results of the LEANer study (Lifestyle, Exercise, and Nutrition Early After Diagnosis) in women with breast cancer. It showed that patients with newly diagnosed disease who were just starting chemotherapy could improve physical activity and diet quality. While both groups had high rates of treatment completion, women in the intervention who exercised at or above the recommended levels did better in terms of treatment completion, with fewer dose reductions and delays (Abstract 12007).

 

Advertisement

Advertisement




Advertisement