PCRI's Executive Director, Mark Scholz, MD, describes the current state of genetic testing in the treatment of advanced prostate cancer and provides a few examples of the most useful tests available at the moment.
0:15 The standard treatments for advanced prostate cancer (hormone therapy, chemotherapy) will typically lose potency over time. Genetic testing allows doctors to see if certain mutations have occurred in the cancerous tumors that will make someone's it vulnerable to other non-standard treatments.
0:58 Traditionally biopsies would need to be taken to retrieve genetic information about a tumor. It was uncomfortable and unreliable. Now, however, there are blood tests that check for genetic information that has been released from the tumor into the bloodstream. Guardant 360 and FoundationOne are two examples, but there are others on the market.
1:38 There are a lot of possible mutations that can occur with prostate cancer, but physicians are most interested in the ones that can lead to new treatments. For example, the mutations BRCA, CHEK2, and ATM open up prostate cancer to be susceptible to a medicine called Olaparib, a medicine used to treat ovarian cancer. The mutations occur in about 10% of men, so it's worth checking to see if it would be effective in your case if you are running out of options. It has symptoms comparable to mild chemotherapy.
2:40 Microsatellite Instability (MSI) is a mutation that only occurs in about 1-2% of men. Normally, Keytruda, a type of immune therapy, will only be effective in about 10-20% of men; however, it is nearly 100% effective in men with the MSI mutation. Although it's a rare mutation, it's simple to test for and can totally change the outcome for someone for whom it's relevant.
3:39 When prostate cancer becomes resistant to hormone therapy, typically drugs like Xtandi, Erleada, and Zytiga can put the disease back into remission. The AR-V7 mutation, however, provides an indication that these second-generation hormone therapies are going to be ineffective.
4:28 So far genetic testing has only been effective for finding better treatments for niche groups. Hopefully, further advances in the field will eventually lead to broader application.
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The Prostate Cancer Research Institute (PCRI) is a 501(c)(3) not-for-profit organization that is dedicated to helping you research your treatment options. We understand that you have many questions, and we can help you find the answers that are specific to your case. All of our resources are designed by a multidisciplinary team of advocates and expert physicians, for patients. We believe that by educating yourself about the disease, you will have more productive interactions with your medical professionals and receive better-individualized care. Feel free to explore our website or call our free helpline at 1 (800) 641-7274 with any questions that you have. Our Federal Tax ID # is 95-4617875 and qualifies for maximum charitable gift deductions by individual donors.
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