ASCO 2018: Genomics Versus Genetics and Implications for Prostate Cancer Care
Chicago, IL (UroToday.com) In this talk in the education session on practical methods for integrating genetic testing in clinical practice for advanced prostate cancer, Heather Cheng, MD, led off with the “what and why” component – recognizing common germline mutations that may be present in men with prostate cancer and which patients may benefit from genetic testing.
Prostate cancer is a highly heritable disease. While family history has always been important, it has taken on new implications in the recent past. Family history beyond family history of prostate cancer is critical. A few genes matter (BRCA2, BRCA1, Lynch syndrome, HOXB1, etc). BRCA2 mutation carriers have a 3-9 fold increase in PCa and it is more aggressive/lethal! At this time, however, clinical management has not differed in advanced disease.
ASCO 2018: Prostate Radiotherapy in Newly-Diagnosed Metastatic Hormone-Sensitive Prostate Cancer: A Single-Institution Experience
Chicago, IL (UroToday.com) In the setting of metastatic prostate cancer without prior definitive therapy to the prostate, the role of therapy to the prostate is not clearly defined. Retrospective series have suggested potential benefit to either radiotherapy or prostatectomy in these patients, though the benefit appears to be primarily for patients with oligometastatic or low volume disease.
ASCO 2018: The Complete Genomic Landscape of Metastatic Prostate Cancer Pinpoints Clinically Targetable Subgroups
Chicago, IL (UroToday.com) There is a significant degree of heterogeneity in the pathophysiology and cancer biology of prostate cancer, as well as other malignancies. Unfortunately, current histopathologic classifications have limitations, and while they can predict clinic course relatively well, there continues to be some degree of subjectivity and interobserver variability in classification – and tumor heterogeneity even within a single histopathologic class. The hope has long been that molecular classification systems, either alone or in combination with current histopathology and clinical variables, can help overcome some of those deficiencies.
ASCO 2018: Abi Race: A Prospective, Multicenter Study of Black and White Patients with Metastatic Castrate Resistant Prostate Cancer Treated with Abiraterone Acetate and Prednisone
Chicago, IL (UroToday.com) Black men have 2.5 times greater likelihood of dying from prostate cancer but have been under represented in phase 3 trials.  Black men have been demonstrated to have longer radiographical progression free survival (RPFS) when treated with abiraterone, compared to the overall population, in the COU- 302 trial.  To support the hypothesis that black men have a greater PSA response rate than white men to abiraterone, the authors performed a multicenter prospective parallel group study of abiraterone in men with metastatic castrate resistant prostate cancer (mCRPC) to evaluate outcome by race (NCT01940276).
ASCO 2018: Oligometastasis from Conception to Treatment
Chicago, IL (UroToday.com) Ralph R. Weichselbaum, MD gave an interesting overview of oligometastatic disease in different cancers. The topics covered in this talk included the oligometastasis hypothesis, biological basis of oligometastasis, evidence for the use of ablative therapies in the curative treatment of patients with oligometastasis, and integration of cytoreductive therapy with systemic therapy.
ASCO 2018: When Your Patient 'Friends' You: Appropriate Communication With Patients and Families Online
Chicago, IL (UroToday.com) Dr. Markham gave an interesting talk about a topic not often discussed but with great importance in this age of social media usage and expansion. She presented her views on the appropriate communication between doctors and their patients and families online.
ASCO 2018: Practical Guidance on Genetic Counseling Without Genetic Counselor Support
Chicago, IL (UroToday.com) In this last talk in the education session on practical methods for integrating genetic testing in clinical practice for advanced prostate cancer, Ms. Powers, a genetic counselor at Abramson Cancer Center at the University of Pennsylvania, provided an excellent practical guide to genetic counseling without a genetic counselor – she had some very important take-home points.
Ultimately, a good portion of what she talked about is technical – related to the testing process and the results returned. However, I will highlight some of her important points along the way.