Dr. Giri on Genes that Carry a Risk for Prostate Cancer

Veda Giri, MD, associate professor, Thomas Jefferson University Hospital, discusses genes that are associated with a risk of developing prostate cancer.

The genes that have had the greatest association of risk for prostate cancer are BRCA1/2. BRCA2 has been associated with aggressive prostate cancer. HOXB13 is another hereditary prostate cancer gene that doesn’t have a role in guiding management for advanced or metastatic disease, but does seem to confer some of the highest risks for prostate cancer. How to incorporate it into screening is also being studied, says Giri.

Other DNA mismatch-repair genes such as MLH1, MSH2, PMS2, MSH6 that are linked with Lynch syndrome, a hereditary colon cancer syndrome, can also be very important in terms of considering clinical trials for men with advanced prostate cancer.

Additional genes in the repair pathways are also of importance, particular in men with metastatic disease in terms of guiding their treatment, states Giri. The current NCCN guidelines have expanded beyond BRCA1/2 to PALB2 and FANCA. Sidney Kimmel Cancer Center at Thomas Jefferson University Hospital hosted a consensus conference in which experts expanded the genetic testing for men with prostate cancer and included genes like ATM and the DNA mismatch-repair genes.