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Updates in NCCN Guidelines for Molecular Testing in Prostate Cancer

James Mohler, MD
Published Online:2:59 PM, Wed October 16, 2019

James Mohler, MD, associate director for translational research and a professor of oncology at Roswell Park Comprehensive Cancer Center, discusses the rationale for the latest updates to the National Comprehensive Cancer Network (NCCN) guidelines for genetic testing in prostate cancer.

Mohler says the most important update has been making clear what a family history should consist of when addressing a man with prostate cancer. Too often, the family history is recorded as positive or negative, sometimes including what relative had prostate cancer, but the family history does not capture the age of diagnosis, treatment received, and whether or not the disease led to either metastatic disease or death in that relative.

The updates to the NCCN guidelines prescribed what family history should be collected, as well as other things that should be captured, such as hereditary syndromes. Most importantly, the updates also noted the importance of identifying where a family member with prostate cancer is in the family tree. By doing a better job at capturing family history, this information can be utilized more in clinical practice, says Mohler.

Mohler says the updates also addressed the minimum number of genes that should be assayed for mutations in a patient with prostate cancer. The NCCN called for more clinical trials to help determine whether taking action based on these new updates for molecular testing can really impact patients with prostate cancer.
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