Welcome to the Center of Excellence “nonmetastatic castration-resistant prostate cancer” (nmCRPC) delivering clinical perspectives from multidisciplinary experts.
Prof Heather Payne, Dr Neal Shore, Dr Eleni Efstathiou, Prof Nicolas Motte
Neal D. Shore, Stephen A. Boorjian, Daniel J. Canter, Kenneth Ogan, Lawrence I. Karsh, Tracy M. Downs, Show More
N.D.S., S.A.B., and D.J.C. contributed equally to the study.
SALT LAKE CITY, Jan. 22, 2018 (GLOBE NEWSWIRE) — Myriad Genetics, Inc. (NASDAQ:MYGN), a leader in molecular diagnostics and personalized medicine, announced today that the company is applauding a new consensus statement from a team of international experts with screening recommendations on hereditary prostate cancer that was published in the Journal of Clinical Oncology. The consensus recommendations point to the need for routine obtainment of family history information and hereditary cancer counselling for men with prostate cancer seen by either a urologist or oncologist.
“Prostate cancer patients have been an underserved community with genetic testing and metastatic patients face one the highest hereditary cancer mutation rates. Despite this fact, we estimate less than 10 percent of men who meet criteria for hereditary prostate cancer in the United States are tested today.” said Nicole Lambert, General Manager, Urology, Myriad Genetics. “As the global leader in hereditary cancer testing we are dedicated to driving education and awareness for patients and physicians around the risks of hereditary prostate cancer. For example, we have recently taken steps to further enhance myRisk Hereditary Cancer, our market leading test for hereditary cancer with the recent addition of the HOXB13 gene which has been linked to hereditary prostate cancer risk. ”
Recently the National Comprehensive Cancer Network (NCCN) updated their professional guidelines to support hereditary cancer testing for all men with metastatic prostate cancer which built upon previous testing recommendations for men with advanced prostate cancer and a family history of cancer. “It has become increasingly apparent that hereditary cancer mutations play a significant role in assessing individual patient prostate cancer risk as well as having an increasingly impactful effect in patient therapeutic selection ,” said Neal D. Shore, M.D., President of the Large Urology Group Practice Association (LUGPA). “Knowing specific genetic information may not only affect the life of a prostate cancer patient but may also potentially affect the lives of his family members.”
For more information talk with your doctor, visit www.myriad.com or take the www.hereditarycancerquiz.com.
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Distinguishing between low- and high-grade prostate cancers (PCa) is important, but biopsy may underestimate the actual grade of cancer. We have previously shown that urine/plasma-based prostate-specific biomarkers can predict high grade PCa. Our objective was to determine the accuracy of a test using cell-free RNA levels of biomarkers in predicting prostatectomy results.
This multicenter community-based prospective study was conducted using urine/blood samples collected from 306 patients. All recruited patients were treatment-naïve, without metastases, and had been biopsied, designated a Gleason Score (GS) based on biopsy, and assigned to prostatectomy prior to participation in the study. The primary outcome measure was the urine/plasma test accuracy in predicting high grade PCa on prostatectomy compared with biopsy findings. Sensitivity and specificity were calculated using standard formulas, while comparisons between groups were performed using the Wilcoxon Rank Sum, Kruskal-Wallis, Chi-Square, and Fisher’s exact test.
GS as assigned by standard 10-12 core biopsies was 3 + 3 in 90 (29.4%), 3 + 4 in 122 (39.8%), 4 + 3 in 50 (16.3%), and > 4 + 3 in 44 (14.4%) patients. The urine/plasma assay confirmed a previous validation and was highly accurate in predicting the presence of high-grade PCa (Gleason ≥3 + 4) with sensitivity between 88% and 95% as verified by prostatectomy findings. GS was upgraded after prostatectomy in 27% of patients and downgraded in 12% of patients.
This plasma/urine biomarker test accurately predicts high grade cancer as determined by prostatectomy with a sensitivity at 92-97%, while the sensitivity of core biopsies was 78%.
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Dr. Neal Shore discusses the evolving interest in Alpha-Emitting Radionuclide Therapy over the past 20 years, which is due to advances in the targeted delivery of radionuclides as well as increased availability of many different alpha emitters. These developments have led to a number of clinical trials in this space, particularly with Radium-223, which is the only targeted alpha-emitter therapy currently approved for use on mCRPC patients.
There is no evidence that a resistance mechanism can develop to a targeted alpha therapy (TAT), so Dr. Shore addresses ways to link payloads of other diagnostic entities to TAT. He also explores TAT’s biological consequences, what we’ve learned from radium-223, the first-in class TAT, and combining TAT with immunotherapy treatment, DNA repair inhibitors and hormonal therapy to enhance therapeutic benefit for the patient.
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Dr. Neal Shore addresses both the perception and evidence of side effect for patients on androgen deprivation therapy (ADT). There is a growing concern about ADT side effects now that it is being used more in non-metastatic prostate cancer, which is exposing men to ADT for longer periods of time. Several common adverse effects are known about ADT impacting multiple organ systems including the central nervous system, as well as the hematologic, reproductive, musculoskeletal and endocrine systems. Researchers are also now taking a closer look at the link between ADT and cognitive impairment, particularly dementia. Dr. Shore also discusses studies examining ADT’s effect on the metabolic and cardiovascular function of prostate cancer patients.
Charles Ryan, MD sits down with Neal Shore, MD president of the Large Urology Group Practice Association (LUGPA) who shares with listeners an overview of the 8th CME program a prelude to the annual LUGPA meeting and the agenda at this year’s LUGPA meeting. The 2017 topic for the LUGPA CME session is Updates for Optimizing GU Oncology Cancer Clinics of Excellence of which the topic at this year’s meeting has been expanded to both bladder and kidney cancer. Dr. Shore gives a brief overview of the topics, presentations and speakers who took the stage.
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