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PEER-TO-PEER CLINICAL CONVERSATIONS |
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VA's Million Veterans Program Reveals Crucial Genetic Data for Prostate Cancer Treatment
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Bruce Montgomery, MD
Bruce Montgomery discusses the pivotal role of germline testing in cancer predisposition, particularly within the Million Veterans Program. Focusing on prostate cancer, Dr. Montgomery explains that germline testing, which examines inherited DNA, can identify individuals with genetic predispositions to various cancers, including prostate, breast, ovarian, and pancreatic.
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Genetic Testing Reveals Treatment Opportunity and Disparity in Advanced Prostate Cancer
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Colin Pritchard, MD, Ph.D.
Zach Klaassen engages with Colin Pritchard in a detailed discussion about genomic testing in prostate cancer. They emphasize the importance of genomic testing, particularly in advanced prostate cancer, for treatment decisions and family counseling.
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NCCN 2024 Prostate Cancer Guidelines Update: PARP Inhibitors in Focus
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Rashid Sayyid, MD, MSc, and Zachary Klaassen, MD, MSc
Rashid Sayyid and Zach Klaassen discuss the 2024 updates to the NCCN Prostate Cancer Guidelines. They focus on non-hormonal systemic therapy, highlighting significant changes, particularly the emergence of PARP inhibitors like olaparib and rucaparib.
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| The Use of PARP Inhibitors in mCRPC with BRCA1/2 Alterations |
| Joaquin Mateo, MD, Ph.D. |
| Alicia Morgans speaks with Joaquin Mateo about his presentation on PARP inhibitors. Dr. Mateo discusses the role of PARP inhibitors in treating mCRPC with BRCA1 or BRCA2 mutations, noting the poor prognosis associated with these mutations but highlighting the effectiveness of PARP inhibitors like olaparib and rucaparib. |
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| Practical Approach to Genetic Testing and Treatment Selection in Prostate Cancer
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| David James VanderWeele, MD, Ph.D.
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| David James VanderWeele discusses a practical approach to genetic testing and treatment selection in prostate cancer. He highlights the significance of early somatic and germline testing, especially for patients with high-risk or metastatic hormone-sensitive prostate cancer. Genetic mutations such as BRCA2 were shown to influence treatment response and prognosis, emphasizing the importance of personalized medicine in optimizing patient outcomes.
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| Race and Decisional Conflict About Genetic Testing in Patients with Advanced Prostate Cancer |
| James Purtell, MD |
| James Purtell presents a study on racial differences and decisional conflicts regarding genetic testing in patients with advanced prostate cancer. The study revealed that non-white patients expressed more concerns about privacy, data misuse, and unproven treatments compared to white patients, but no significant differences in testing completion or overall decisional conflict were observed between racial groups. |
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| Synchronous mHSPC: What Are the Treatment Options and What Are the Goals of Treatment? Germline Genetic Testing Necessary And/or Helpful? |
| Elena Castro, MD, MS, Ph.D. |
| Elena Castro discusses the necessity and benefits of germline genetic testing for patients with synchronous metastatic hormone-sensitive prostate cancer. She highlights that a significant portion of prostate cancer risk is attributable to genetic factors, particularly BRCA2 mutations, and emphasizes the importance of germline testing for prognosis, treatment decisions, and assessing familial cancer risk. |
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| PARP Inhibition Dissected – in Which DNA Repair Gene Alterations Works Which PARP Inhibitor?
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| Johann de Bono, MD, MSc, Ph.D., FRCP, FMedSci |
| Johann De Bono discusses the heterogeneity of prostate cancer and its implications for treatment with PARP inhibitors. He highlights that prostate cancer varies widely among patients and within individual tumors, complicating treatment strategies. PARP inhibitors target specific DNA repair defects, notably in genes like BRCA1/BRCA2, PALB2, and ATM, which show varying responses based on the nature of the mutations.
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| PARP-Inhibitors Only for Patients with Alterations in DNA Repair Genes: The Guidelines' View
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| Maria De Santis, MD, Ph.D.
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| Maria De Santis discusses guidelines for using PARP inhibitors in metastatic prostate cancer patients with DNA repair gene alterations. She emphasized that all metastatic patients should undergo somatic genomic testing for homologous repair and MMR defects early on. The EAU guidelines recommend combination therapies involving ARPIs and PARP inhibitors for mCRPC patients with specific HRR or BRCA mutations, highlighting significant rPFS benefits primarily driven by these mutations, while noting substantial side effects and the lack of overall survival benefit for patients without these mutations.
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