Dr. Shore on the Need for Further Education on Molecular Testing in mCRPC

Neal D. Shore, MD, FACS, medical director of the Carolina Urologic Research Center, discusses the need for further education on molecular testing for metastatic castration-resistant prostate cancer (mCRPC).

The field of prostate cancer has begun to adopt the 2017 National Comprehensive Cancer Network (NCCN) molecular testing for homologous recombination repair (HRR) gene alteration guidelines, says Shore. During the 2020 ESMO Virtual Congress, a retrospective review of the large US Flatiron Health database was presented. Results demonstrated only a modest increase of testing for HRR alternations in patients with mCRPC after 2017 when the NCCN recommendations were changed. Part of that is based upon a need for additional education on the differences between both germline versus somatic testing, according to Shore.

The utility for finding someone with an HRR mutation is necessary now that PARP inhibitors have been approved, explains Shore. There are other gene alterations where checkpoint inhibitors may be of value, particularly when there are tumor agnostic findings. As the field continues to evolve, there is a need for additional education across all specialties, including medical oncology, urology, and radiation oncology, concludes Shore.