Genomic Testing Impacts Treatment Decisions in Prostate Cancer

June 29, 2020

Eric A. Klein, MD, discusses the role of genomic testing in patients with prostate cancer and how these findings can impact treatment decisions.

Eric A. Klein, MD, chairman, Glickman Urological & Kidney Institute, and staff member, Taussig Cancer Institute, Cleveland Clinic, discusses the role of genomic testing in patients with prostate cancer and how these findings can impact treatment decisions.

Like with many other cancer tumors, there are tools available to evaluate the genome of prostate cancers, says Klein. One way to look at this is to focus on men with metastatic disease where genotyping the metastatic tumor can dictate treatment. For example, rucaparib (Rubraca) was approved by the FDA and can be used to treat patients with a BRCA mutation. This PARP inhibitor has been shown to improve survival in this setting.

A few years ago, there were 4 agents available on the market, which helped determine molecular aggressiveness of early-stage prostate cancer, according to Klein. Genomic testing helps determine clinical decision making in terms of deciding who is a good candidate for active surveillance, says Klein. Physicians need to know who may need to be treated because of a worrisome cancer hiding in the prostate cancer that was missed by an initial biopsy and who may benefit from early radiation therapy after a radical prostatectomy.

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