June 11, 2020 -- All men with metastatic prostate cancer or a family history suggesting hereditary risk should be getting genetic testing, experts recommended in an article published June 9 in the Journal of Clinical Oncology.
The article from Dr. Veda Giri of Sidney Kimmel Cancer Center at Thomas Jefferson University and colleagues reflects a review of germline and somatic testing in prostate cancer discussed at an international multidisciplinary consensus conference held October 4 to 5. The meeting – the Philadelphia Prostate Cancer Consensus Conference 2019: Implementation of Germline Testing for Prostate Cancer, was hosted by Sidney Kimmel Cancer Center at Thomas Jefferson University.
To ensure access to personalized treatments and clinical trials, stakeholders at the meeting called for testing all men with metastatic prostate cancer and also men with a family history that suggests hereditary risk for prostate cancer and other tumor types. According to the group, large germline panels and somatic testing are recommended and screening for certain mutations should be prioritized: BRCA1, BRCA2, and DNA mismatch repair genes.
Routine use of genetic testing has real-world implications for patients as two poly (ADP-ribose) polymerase (PARP) inhibitors were just approved for subtypes of metastatic castration-resistant prostate cancer. Last month, the U.S. Food and Drug Administration approved rucaparib (Rubraca) for patients with germline or somatic BRCA mutations and olaparib (Lynparza) in those with germline or somatic homologous recombination repair-mutated disease.
Despite its value in finding mutations that are actionable, however, genetic testing of men for prostate cancer is "still not common practice due to inconsistent guidelines and challenges to implementation of genetic counseling," conference sponsors said in a statement about the just-published recommendations.