Real-world genomic testing patterns in patients with prostate cancer.

Authors

null

Dalia Kaakour

University of California, Irvine, Orange, CA

Dalia Kaakour , Nataliya Mar

Organizations

University of California, Irvine, Orange, CA, University of California, Irvine Health, Orange, CA

Research Funding

No funding sources reported

Background: The armamentarium of therapies for metastatic prostate cancer (PCa) has now expanded to include genomically targeted agents and CPIs. Men with both somatic and germline alterations in the DNA damage repair (DDR) pathway, most commonly BRCA2, are candidates for PARP inhibitors. Recent data from the PROPEL and MAGNITUDE trials led to approval of PARP inhibitors in combination with novel hormonal therapies earlier in the PCa continuum, in the first-line metastatic castrate-resistant space. Some PCas harbor genomic alterations, such as TMB>10 m/Mb and MSI high, which predispose to increased responses to CPIs, leading to tumor agnostic approval of pembrolizumab in these patient populations. However, it is imperative to perform timely genomic testing to assess for presence of these alterations. Methods: We conducted a 15-question survey using the Qualtrics XM software to assess genomic testing patterns of various providers in academic and community settings managing PCa patients. The survey link was distributed electronically to providers predominantly in the Western United States. Results: A total of 47 survey responses were received, with 59.6% (28/47) self-identifying as medical oncologists (Onc), 21.3% (10/47) as urologists (Uro), 4.3% (2/47) as radiation oncologists, 8.5% (4/47) as advanced practitioners, and 6.4% (3/47) as other. Academic Onc comprised 23.4 % (11/47), community Onc comprised 36.2% (17/47), academic Uro comprised 17.0% (8/47), and community Uro comprised 4.6 % (2/47) of providers. Timing of ordering of germline and somatic genomic testing by selected provider type is outlined in the Table. Conclusions: Given availability of targeted therapies in PCa management, ordering germline and somatic germline genomic testing is imperative. Despite the small sample size, several trends emerge from this dataset. Oncs at academic centers tend to order genomic testing earlier than Oncs at community practices, while Uros were less likely to order genomic testing when compared to Oncs in general.

Timing of ordering of genomic testing by provider type.

Type of genomic testingProvider
type
Localized PCaBiochemical recurrenceLocally advanced PCamCSPCmCRPCOnly if high risk based on family historyNever orderOtherN/A
GermlineAcademic Onc18.2% (2/11)0% (0/11)36.4% (4/11)9.1% (1/11)9.1% (1/11)9.1% (1/11)0% (0/11)18.2% (2/11)0% (0/11)
Community Onc0% (0/17)17.6% (3/17)0% (0/17)47.1% (8/17)5.9% (1/17)17.6% (3/17)0% (0/17)5.9% (1/17)5.9% (1/17)
Academic Uro12.5% (1/8)0% (0/8)12.5% (1/8)12.5% (1/8)0% (0/8)25% (2/8)25% (2/8)12.5% (1/8)0% (0/8)
SomaticAcademic Onc18.2% (2/11)0% (0/11)27.3% (3/11)36.4% (4/11)18.2% (2/11)0% (0/11)0% (0/11)0% (0/11)0% (0/11)
Community Onc0% (0/17)0% (0/17)5.9% (1/17)41.2% (7/17)35.3% (6/17)0% (0/17)11.8% (2/17)0% (0/17)5.9% (1/17)
Academic Uro12.5% (1/8)0% (0/8)(25.0% (2/8)(25.0% (2/8)0% (0/8)0% (0/8)37.5% (3/8)0% (0/8)0% (0/8)

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Abstract Details

Meeting

2024 ASCO Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Quality of Care/Quality Improvement and Real-World Evidence

Citation

J Clin Oncol 42, 2024 (suppl 4; abstr 97)

DOI

10.1200/JCO.2024.42.4_suppl.97

Abstract #

97

Poster Bd #

D12

Abstract Disclosures

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