167P - Genetic testing for prostate cancer: The Indian scenario

Background

Prostate cancer (PrCa) incidence is on the rise and was the 12th commonest cancer in India (GLOBOCAN 2020). Genetic testing for PrCa has been widely advocated owing to its poor prognosis, familial risks associated with underlying mutations and therapeutic implication of these mutations. Data on genetic testing practices related to PrCa among Indian medical and uro-oncologists is meagre. With the availability of mutation-based targeted treatment for PrCa, there exists a need to assimilate the current practice patterns in genetic testing.

Methods

An online questionnaire comprising 12 objective questions was developed, validated by a panel of 9 experts, and distributed. Responses were collected over 2 months, at the end of which 103 medical and uro-oncologists responded. Results were descriptively analysed and concluding statements on current practice patterns and future trends were formulated.

Results

Genetic testing was advised by 64.1% of the oncologists for most PrCa patients. A majority chose to advise genetic testing at the stage of castration-resistant prostate cancer (58.3%). Patients with a positive family history of PrCa were most commonly referred for genetic testing (88.3%). Blood and primary tumor were the preferred specimens sent for testing. A 15-gene panel that play a crucial role in the homologous recombination repair (HRR) pathway was most commonly used (50.2%). Testing of the tumor followed by blood samples was the sequence most commonly followed (44.7%). The primary tumor provided maximum yield on testing for the mutations (42.7%). As per 64.1% of the oncologists, the positivity rate for prostate cancer was <5%. National Comprehensive Cancer Network (NCCN) guidelines were followed by 68.9% of oncologists. Major barriers to genetic testing were affordability (89.3%) and lack of genetic counsellors (70.9%).

Conclusions

Testing for genetic mutations in PrCa is a prevalent practice among oncologists in India. Making genetic testing more affordable through patient-assistance programs and increased awareness of the utility of genetic testing along with the availability of genetic counsellors would help improve access to drugs and facilitate better diagnosis and treatment of PrCa in India.

Clinical trial identification

Editorial acknowledgement

Authors would like to thank AstraZeneca Pharma India Limited in collaboration with BioQuest Solutions PVT. Ltd. India for medical writing assistance.

Legal entity responsible for the study

AstraZeneca Pharma India Limited.

Funding

AstraZeneca Pharma India Limited.

Disclosure

All authors have declared no conflicts of interest.