Dr Maxwell on Real-World Germline Variant Rates in Prostate Cancer

Kara N. Maxwell, MD, PhD, assistant professor, medicine (hematology-oncology), Department of Medicine, Perelman School of Medicine, University of Pennsylvania, discusses key takeaways from a real-world investigation of germline mutation rates in patients with metastatic prostate cancer.

A recent study focusing on patients with metastatic prostate cancer has revealed that the real-world prevalence of DNA repair pathogenic germline variants is lower than the rate reported in prior literature. The patient cohort in this analysis included those who underwent genetic testing either through a point-of-care model at the Basser Center of Penn Medicine or through cancer genetics practices at the VA Philadelphia Health Care and VA Greater Los Angeles Health Care.

The increasing number of patients with metastatic prostate cancer, particularly in the oligometastatic setting, means that radiation oncologists and urologists are encountering more of these cases, Maxwell explains. Therefore, it is crucial for healthcare providers managing patients with metastatic prostate cancer to proactively discuss the option of genetic testing with their patients, she reports.

Maxwell emphasizes that although a patient may not present with a genetic alteration, understanding how to identify and treat these alterations can significantly inform the selection of future treatment options, such as PARP inhibitors. Moreover, the implications of genetic findings extend beyond individual patients, potentially guiding family health decisions and screening practices, she states.

Implementing genetic testing in clinical practice should be a priority, Maxwell continues, adding thatthis can be done efficiently and can yield valuable information for both treatment planning and familial risk assessment. The support for this research from the Basser Center for BRCA at the University of Pennsylvania underscores its importance. As the director of the Men & BRCA Program, Maxwell concludes that she is enthusiastic about how this research can enhance genetic testing rates and improve knowledge of disease among all men with cancer.