Kara N. Maxwell, MD, PhD, discusses strategies to optimize the utility of genetic testing to better inform decision-making in prostate cancer treatment.

Dr Maxwell on Strategies to Optimize Genetic Testing in Metastatic Prostate Cancer

Kara N. Maxwell, MD, PhD, assistant professor of medicine (hematology-oncology), Department of Medicine, Perelman School of Medicine, University of Pennsylvania, discusses how findings from a study evaluating the real-world rates of pathogenic germline variants in patients with metastatic prostate cancer may optimize the use of genetic testing to inform treatment decision-making.

This prospective study analyzed pathogenic germline variants in 3 cohorts of patients with metastatic prostate cancer. Patients had either received genetic testing through a point-of-care model at the Basser Center of Penn Medicine, or through cancer genetics practice at the VA Philadelphia health care or VA Greater Los Angeles health care.

 demonstrate consistent rates of pathogenic germline variants associated with prostate cancer across diverse patient populations, irrespective of racial differences. Notable discrepancies were observed in variants of uncertain significance, correlating with the racial diversity of each cohort. Moreover, the incidence of DNA repair pathologic germline variants in this study was lower than what prior research had suggested.

Overall, the study underscores the importance of genetic testing in metastatic prostate cancer, particularly given the lower rates of high-yield genetic findings in this patient population, Maxwell emphasizes. Despite the clinical relevance of genetic testing, rates remain low in men with metastatic prostate, pancreatic, and male breast cancers, indicating a critical need to optimize testing strategies, Maxwell states. In response, efforts are underway to implement streamlined genetic testing approaches, such as point-of-care models seen at institutions like the Basser Center of Penn Medicine or nurse-embedded models within the VA system, she details. These innovative strategies aim to increase testing accessibility and efficiency, ensuring that all patients with metastatic prostate cancer have access to genetic testing that can inform personalized treatment decisions, Maxwell explains.

Moving forward, future trials and initiatives within the Basser Center at Penn Medicine are focused on advancing genetic testing approaches to enhance uptake and utilization among metastatic prostate cancer patients and their healthcare providers, Maxwell reports. By promoting wider adoption of genetic testing in clinical practice, researchers aim to improve patient outcomes and advance precision medicine in the management of metastatic prostate cancer, she concludes.

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Dr Maxwell on Strategies to Optimize Genetic Testing in Metastatic Prostate Cancer  

Dr Maxwell on a Study of Genetic Testing in Metastatic Prostate Cancer

Kara N. Maxwell, MD, PhD, assistant professor of medicine (hematology-oncology), Department of Medicine, Perelman School of Medicine, University of Pennsylvania, discusses a study of genetic testing results for patients with metastatic prostate cancer.

The study included cohorts of patients with metastatic prostate cancer in a point-of-care model at Basser Center of Penn Medicine, as well as patients from a cancer genetics practice at the Corporal Michael Crescenz VA Medical Center in Philadelphia. Maxwell and colleagues sought to evaluate the rates of pathogenic germline variants in the context of broader, more diverse patient populations.

Various institutions have implemented different models to streamline genetic testing processes, Maxwell says. Notably, some have integrated nurses into oncology programs to facilitate this testing.

Findings presented at the 2024 AACR Annual Meeting showed that despite differences in the racial breakdowns of each cohort of patients, the prevalence of pathogenic germline variants associated with prostate cancer remained consistent across the cohorts, Maxwell explains. This finding underscores the uniformity of mutation rates across diverse racial groups, challenging previous assumptions regarding racial disparities in genetic mutation prevalence, she continues.

However, difference in rates of variants of uncertain significance were observed, correlating with the racial diversity of each cohort. This suggests that although pathogenic mutation rates appeared to remain consistent, the significance and interpretation of genetic variants may differ among populations, Maxwell explains. Nonetheless, the study underscores the importance of genetic testing for all patients with metastatic prostate cancer and its potential to inform personalized treatment approaches.

By analyzing a cohort of 1000 individuals with metastatic prostate cancer, the study provides a comprehensive population-level perspective on genetic testing, Maxwell says. These data can help enrich the understanding of mutation prevalence beyond traditionally high-risk populations, offering insights into broader demographic representations, she concludes.

Kara Maxwell, MD, PhD discusses a study of genetic testing results in metastatic prostate cancer. 

Kara N. Maxwell, MD, PhD

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Dr Maxwell on Strategies to Optimize Genetic Testing in Metastatic Prostate Cancer

Dr Maxwell on a Study of Genetic Testing in Metastatic Prostate Cancer