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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Biomarker-Directed Therapy in Men with Metastatic Castration-Resistant Prostate Cancer (mCRPC)
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Clara Hwang, MD
Clara Hwang shares an overview of her ASCO 2022 presentation on biomarker-directed therapy in men with mCRPC. She explains how the research was motivated by the known disparities in Black versus White men regarding prostate cancer diagnosis and prognosis.
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| Real-World Understanding of the Prevalence of Potentially Targetable DNA Damage Repair Alterations – The PROMISE Registry |
| Heather H. Cheng, MD, Ph.D. |
| Heather Cheng joins Alicia Morgans to discuss the trial in progress poster presented at GU ASCO 2022 on the PROMISE Registry. The goal of the PROMISE registry is to offer genetic testing for men with prostate cancer regardless of the stage of their disease. The registry will recruit over five years, with fifteen years of planned follow-up. |
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EDITOR SELECTED ABSTRACTS AND COMMENTARIES |
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| Biomarker-Directed Therapy in Black and White Men With Metastatic Castration-Resistant Prostate Cancer |
| Clara Hwang, MD |
| Clara Hwang presents an analysis of biomarker-directed therapy in men with metastatic castration-resistant prostate cancer (mCRPC). Despite identified worse outcomes (higher incidence and mortality) in Black men with prostate cancer, Black men have been underrepresented in large-scale molecular prostate cancer surveys. Given that molecular profiling to guide the use of targeted agents is gaining an increasingly important role in mCRPC, these authors compared precision medicine data and utilization in a cohort of black and white men with mCRPC. |
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| Implications of Androgen Receptor (AR) Alterations Identified by Genomic Testing of Tissue and Blood from Advanced Prostate Cancer (aPC) Patients |
| Zeynep Zengin, MD |
| Novel androgen receptor targeted agents (ARTA) are effective in improving patient outcomes across the spectrum of prostate cancer disease states. Resistance to ARTAs eventually develops in advanced prostate cancer, and a broader understanding of the mechanisms promoting this resistance is required. Mutations within the androgen receptor (AR) gene itself have been linked to anti-androgen resistance. Indeed, two publications in 2013 linked the F876L mutation to enzalutamide resistance. |
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| PROMISE Registry: A Prostate Cancer Registry of Outcomes and Germline Mutations for Improved Survival and Treatment Effectiveness |
| Channing Judith Paller, MD |
| A substantial minority of patients with prostate cancer have germline mutations in genes involved in DNA damage repair. Based on the prevalence of these alterations in advanced disease and the potential therapeutic benefit of targeting germline DNA damage repair vulnerabilities, treatment guidelines recommend genetic testing in high-risk localized, node positive, and metastatic disease. |
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| Toward Equitable Prostate Cancer Care - Discussion |
| Kelvin Moses MD, Ph.D. |
| Kelvin Moses provides a discussion of equitable care in prostate cancer. Dr. Moses makes the impassioned statement (met with a round of applause) that it is within our control as physicians to improve care for our patients, each time we step into the voting booth. He noted that, following the Affordable Care Act, states with Medicare Expansion noted improved screening rates, improved treatment rates, and decreased mortality. Thus a (political) solution is well within reach if only we choose to act upon it. |
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| Racial Concordance and Trust in Health Communications: A Randomized Trial of Videos About Prostate Cancer |
| Stacy Loeb, MD |
Stacy Loeb presents a randomized trial of 2904 U.S. adults age ≥40 that sought to evaluate the association between racial representation in online content about prostate cancer and trust in the content. A secondary objective was to identify additional attributes that influence trust in online content.
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| Germline Genetic Testing in Advanced Prostate Cancer; Practices and Barriers: Survey Results from the Germline Genetics Working Group of the Prostate Cancer Clinical Trials Consortium - Beyond the Abstract |
| Veda N. Giri, MD, Heather H. Cheng, MD, Ph.D., and Channing J. Paller, MD |
| Germline testing for prostate cancer (PCA) is revolutionizing treatment, management, and risk assessment. Pathogenic mutations in multiple DNA repair genes, and particularly BRCA2 and others, are informing targeted therapy options in the metastatic and advanced disease setting, active surveillance discussions in the early-stage setting, and PCA early detection discussions. |
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