Dr. Scher on Predicting Sensitivity to Treatment for mCRPC

Howard I. Scher, MD, chief, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, discusses the genetics of patients with metastatic castration-resistant prostate cancer (mCRPC).

If researchers examine the genetics of the metastatic lesions and primary sites of prostate cancer versus a localized disease, Scher explains, the frequency and types of changes are very different from one another. If there is a focus on treating mCRPC, he says, it is imperative to study the cancer at the time and make a decision to choose an optimal treatment. This is often done via a biopsy of a metastatic lesion, he says.

The most common site of metastases in prostate cancer is the bone, where the ability to do consistent molecular profiling is quite low. The community's experience in using directed biopsies is only about 50%, and it is also an invasive procedure that can be expensive. This is a more difficult situation if patients have 10 individual metastatic lesions, as they are not biologically similar to one another.