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    Current prostate Ca guidelines miss germline variants

    37% of men with high-risk variant would not qualify for genetic testing

    Chicago—Adherence to current guidelines for genetic testing in men with prostate cancer would miss a sizable proportion of patients with pathogenic germline variants, according to a study presented at the American Society of Clinical Oncology annual meeting in Chicago.

    The investigation analyzed data from an unselected population of 1,158 men with prostate cancer who had germline genetic testing performed at a commercial laboratory (Invitae) between 2013 and 2016. The number of genes tested ranged from one to 142, varied in each patient according to the requisition submitted by his physician, and often included 14 genes on the commercial laboratory’s prostate cancer-targeted panel.

    Also see: RT-ADT combo may boost pN1 prostate cancer survival

    One or more high-risk variants, as defined by “Sherloc,” a refined classification system based on American College of Medical Genetics criteria (Genet Med [epub ahead of print] May 11, 2017), was found in 199 men (17.2%). Seventy-three of the men (37%), however, would not have qualified for genetic testing based on the existing National Comprehensive Cancer Network guidelines. In the study, a germline variant was found in 15.4% of patients with a Gleason score ≥7 and in 12.4% of men whose Gleason score was ≤6.

    Oliver Sartor, MD, Laborde Professor of Cancer Research at Tulane School of Medicine, New Orleans, initiated the trial. He told Urology Times, “The take-home message from this study is that the guidelines for genetic testing in men with prostate cancer have to change so that we can better serve these patients and their families with greater access to genetic testing and therapeutic options.”

    Next: New guidelines needed

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