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PEER-TO-PEER CLINICAL CONVERSATIONS |
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| Using Liquid Biopsies in Clinical Practice to Inform Decision Making for Prostate Cancer Care |
Joshua M. Lang, MD, MS
Josh Lang joins Alicia Morgans in a discussion on the importance of understanding mechanisms of resistance to targeted therapies through the development of novel liquid biopsies of the human tumor microenvironment. |
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Comprehensively Mapping Epigenetic Alterations Promoting Lineage Plasticity to Develop Blood-Based Biomarkers to Predict Treatment Outcomes in Prostate Cancer
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Martin Sjöström, MD, Ph.D.
Martin Sjöström joins Alicia Morgans in a conversation on the 2021 Michael and Patricia Berns-PCF Young Investigator Award research studying epigenetic modifications that drive lineage plasticity and treatment resistance in prostate cancer. This research aims to develop a new liquid biopsy biomarker platform for men with prostate cancer.
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Associations of Circulating Cell-Free DNA (cfDNA) and Clinical Outcomes in Metastatic Castrate-Resistant Prostate Cancer (mCRPC): A Discussion on the Data
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Daniel H. Shevrin, MD
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| Joining Alicia Morgans is Daniel Shevrin to discuss questions regarding the validity of cell-free DNA assays, particularly for non-DDR genes, and how this analysis is helping to get a better understanding of the associations of these gene alterations with the cell-free DNA assay in relevant clinical outcomes.
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| The First Multiplex Gene Expression Liquid Biopsy Assay to Assess Potential ARSI Resistant Mechanisms Simultaneously In the Treatment of Metastatic Prostate Cancer |
Zachary Klaassen, MD, MSc and Chris Wallis, MD, Ph.D.
Christopher Wallis and Zachary Klaassen discuss a Journal of Clinical Oncology publication titled, "Prospective Evaluation of Clinical Outcomes Using a Multiplex Liquid Biopsy Targeting Diverse Resistance Mechanisms in Metastatic Prostate Cancer." |
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| Utility of Serum Biomarkers for Predicting Cancer in Patients with Previous Negative Prostate Biopsy - Beyond the Abstract
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| Chan Ming Tow, MD
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| This study aims to review the role of serum biomarkers: prostate-specific antigen (PSA), PSA density (PSAD), total PSA ratio, prostate health index (PHI), and PHI density (PHID), along with magnetic resonance imaging (MRI) for identification of clinically significant prostate cancer (PCa), comparing their utility in patients with persistently raised PSA levels after a prior negative prostate biopsy (PNB).
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| Tumor Molecular Testing – Tissue vs Liquid Biopsy |
| Andrew John Armstrong, MD |
| Andrew Armstrong discusses considerations regarding tumor molecular testing with a focus on implications for tissue-based testing as compared to liquid biopsy. He emphasizes that the rationale of biopsy, regardless of approach, is to inform treatment decisions with the hope that these will improve survival, clinical benefit, and the chance of remission. However, these may also inform other decision making including family counseling, risk reduction, and clinical trial eligibility. |
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| Discussant: Novel Biomarkers in Prostate Cancer: Is the Tissue the Issue?
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| David R. Wise, MD, Ph.D.
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| David Wise provides a discussant presentation of several abstracts assessing the impact of CTCs as prognostic factors in the management of advanced prostate cancer. The first, "Baseline CTC count as a prognostic marker of PSA response and progression in mCSPC". The second, "Circulating tumor DNA Dynamics Associate with Treatment Response and Radiological Progression-Free Survival, and the third, "The comprehensive methylation landscape of mCRPC identifies new phenotypic subtypes".
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| Liquid Biopsy in Prostate Cancer, Where are We Now?
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| Shusuke Akamatsu, MD
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| In this presentation, Shusuke Akamatsu discusses liquid biopsy in prostate cancer. In order to proceed with precision medicine in CRPC, which predominantly metastasizes to the bone, timely evaluation of somatic mutations by liquid biopsy is necessary. CTC and cfDNA are powerful tools to capture the dynamic genomic heterogeneity of CRPC. However, their utility needs to be rigorously tested in large prospective trials before broader clinical application.
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| Differences in the Tumor Genomic Landscape Between African American and Caucasian Patients Advanced Prostate Cancer Patients by Comprehensive Genomic Profiling of Cell-Free DNA
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| Pedro C. Barata, MD, MSc
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| Pedro Barata presents an analysis of the tumor genomic landscape of African American and Caucasian men with prostate cancer, using cfDNA comprehensive genomic profiling. While these data are hypothesis-generating and require external validation, they suggested that differences in the tumor genomic profile between African American and Caucasian patients with advanced prostate cancer may allow for a molecularly targeted treatment approach which will improve treatment outcomes.
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| The Cell-Free DNA Methylome Captures Distinctions Between Localized and Metastatic Prostate Tumors - Beyond the Abstract
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| Sujun Chen and Housheng Hansen He
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| Metastatic lesions of prostate cancer are highly heterogeneous, difficult to biopsy, and usually lethal. Liquid biopsy can provide a more holistic view of the disseminated disease by analyzing cells and biomolecules released into circulation by the tumors. With a technology called cell-free methylated DNA immunoprecipitation coupled with next-generation sequencing, we enrich and sequence the methylated DNA in patient plasma using an anti-5-methylcytosine antibody. This approach allows us to perform genome-wide analysis of the methylated sites.
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