Prostate cancer has entered in a new era of precision medicine with therapies being developed to target the pathways more frequently altered in advanced prostate cancer. In this E-Learning module, the authors present the genomic landscape and actionable alterations in advanced prostate cancer and highlight the findings from the clinical studies that necessitate the changes in clinical practice.
The outline of the module is divided into chapters on genomic testing for precision medicine, prevalence of somatic and germline DNA damage repair (DDR) alterations, impact of DDR alterations in advanced prostate cancer, PARP inhibitors to treat homologous recombination repair (HRR) deficient metastatic castration-resistant prostate cancer (mCRPC), platinum based chemotherapy to treat HRR deficient mCRPC, AKT inhibitors to treat PTEN deficient mCRPC, other targeted therapies under development for advanced prostate cancer, considerations for genomic testing in prostate cancer, and recommendations for germline testing.
Based on the results from recent studies, the authors underline that tumour profiling will be required to select the most appropriate therapy for advanced prostate cancer. Optimisation of tissue collection is critical to improve tumour profiling. Metastatic biopsy is the preferred method for testing, but some early events could be detected in the primary tumours. Liquid biopsy may help overcome some limitations of tissue testing.
Furthermore, the authors emphasise that germline testing should be offered to all men with metastatic prostate cancer and to those with tumour alterations in cancer-predisposition genes.
This E-Learning module provides an excellent overview of results from the recent clinical studies, illustrates the status of guidelines where those findings resulted in change of recommendations for clinical practice and emphasises the need for tumour profiling to select the therapy, as well as for offering germline testing to all men with metastatic prostate cancer.
