Pd21-11 real world impact of germline genetic testing on clinical decision making for prostate cancer patients

You have accessJournal of UrologyCME1 Apr 2023PD21-11 REAL WORLD IMPACT OF GERMLINE GENETIC TESTING ON CLINICAL DECISION MAKING FOR PROSTATE CANCER PATIENTS Neal Shore, Christopher Pieczonka, Mukaram Gazi, Sean Heron, Rishi Modh, David Cahn, Laurence H Belkoff, Aaron Berger, Brian Mazzarella, David Morris, Joseph Veys, Alexander Engelman, Paul Dato, Richard Bevan-Thomas, Robert Cornell, David Wise, Charles Idom, Mary Kay Hardwick, Paige Layman, Kathryn Hatchell, Brandie Heald, Sarah Young, Sarah Young, Robert L Nussbaum, and Edward D. Esplin Neal ShoreNeal Shore More articles by this author , Christopher PieczonkaChristopher Pieczonka More articles by this author , Mukaram GaziMukaram Gazi More articles by this author , Sean HeronSean Heron More articles by this author , Rishi ModhRishi Modh More articles by this author , David CahnDavid Cahn More articles by this author , Laurence H BelkoffLaurence H Belkoff More articles by this author , Aaron BergerAaron Berger More articles by this author , Brian MazzarellaBrian Mazzarella More articles by this author , David MorrisDavid Morris More articles by this author , Joseph VeysJoseph Veys More articles by this author , Alexander EngelmanAlexander Engelman More articles by this author , Paul DatoPaul Dato More articles by this author , Richard Bevan-ThomasRichard Bevan-Thomas More articles by this author , Robert CornellRobert Cornell More articles by this author , David WiseDavid Wise More articles by this author , Charles IdomCharles Idom More articles by this author , Mary Kay HardwickMary Kay Hardwick More articles by this author , Paige LaymanPaige Layman More articles by this author , Kathryn HatchellKathryn Hatchell More articles by this author , Brandie HealdBrandie Heald More articles by this author , Sarah YoungSarah Young More articles by this author , Sarah YoungSarah Young More articles by this author , Robert L NussbaumRobert L Nussbaum More articles by this author , and Edward D. EsplinEdward D. Esplin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003287.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Approximately 10-15% of unselected prostate cancer (PCa) patients (pts) have a pathogenic germline variant (PGV). Identification of a PGV can inform cancer screening, treatment selection, and family cascade testing. Limited data are available on clinician recommendations following germline genetic testing (GGT) in PCa pts. This study collected clinician-reported changes to PCa care (treatment, follow up and cascade testing) based on GGT results. METHODS: An IRB-approved, nationwide, prospective registry recruited unselected, newly (within 12 months of enrollment) or previously diagnosed (>12 months prior to enrollment), PCa pts from 15 community and academic urology practices. Pts underwent an 84-gene panel test and results were grouped as positive (≥1 PGV), VUS (variant(s) of uncertain significance)-only, or negative. Clinician recommendations were collected via electronic case report forms >1-month post GGT. Statistical significance was determined by two-tailed Fisher’s exact test and significance was set at p<0.05. RESULTS: 982 predominantly white (76%), non-metastatic (81%) males with PCa were recruited; 50% met 2019 PCa National Comprehensive Cancer Network (NCCN) GGT criteria. 102 PGVs in 24 cancer risk genes, most commonly CHEK2 and BRCA2 (17 and 10 pts, respectively) were identified in 100 (10%) pts, 50% of whom did not meet GGT criteria. Positive pts were more likely to have changes to treatment, follow up and cascade testing than those with negative or VUS-only results (Table 1). Among positive pts, there were no significant differences in recommendations for pts who met NCCN criteria versus those who did not (Table 1). However, more treatment changes were made for metastatic pts than non-metastatic pts and for those with high-grade (Gleason grade 4/5) compared to medium-to-low-grade disease (Gleason grade <4) (Table 2). CONCLUSIONS: This study showed that GGT did influence PCa pt care and lends support to universal testing of PCa pts. Source of Funding: Research Grant from Invitae © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e594 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Neal Shore More articles by this author Christopher Pieczonka More articles by this author Mukaram Gazi More articles by this author Sean Heron More articles by this author Rishi Modh More articles by this author David Cahn More articles by this author Laurence H Belkoff More articles by this author Aaron Berger More articles by this author Brian Mazzarella More articles by this author David Morris More articles by this author Joseph Veys More articles by this author Alexander Engelman More articles by this author Paul Dato More articles by this author Richard Bevan-Thomas More articles by this author Robert Cornell More articles by this author David Wise More articles by this author Charles Idom More articles by this author Mary Kay Hardwick More articles by this author Paige Layman More articles by this author Kathryn Hatchell More articles by this author Brandie Heald More articles by this author Sarah Young More articles by this author Sarah Young More articles by this author Robert L Nussbaum More articles by this author Edward D. 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