In the case of prostate cancer, a new era of precision medicine is forming.

In the case of prostate cancer is a highly heterogeneous illness. With individual tumor cells exhibiting diverse genetic and phenotypic traits, resulting in a wide range of clinical outcomes for patients.

Sandy Srinivas, MD

Prostate cancer is a highly heterogeneous illness, with individual tumor cells exhibiting diverse genetic and phenotypic traits. Resulting in a wide range of clinical outcomes for patients. Although some prostate cancers grow slowly and may be safely monitored, others grow quickly and aggressively. And without immediate and successful intervention, they can prove fatal. As a result, being able to correctly assess the form of the disease is critical in order to avoid overtreatment of less. Aggressive disease and undertreatment or suboptimal treatment of more aggressive disease, both of which can be fatal.

However, In the case of prostate cancer, A panel of prostate cancer experts highlighted how precision medicine is helping to guarantee that more patients with prostate cancer are appropriately treated during a recent. OncLive Peer Exchange®. They discussed newer diagnostic modalities. Such as liquid tumor profiling, and looked into the role of prostate-specific membrane antigen (PSMA) for diagnostic imaging and treatment via targeted radionuclides. Which are ushering in a potentially new approach to prostate cancer management called theranostics.

“There’s so much variety [in prostate cancer] that our capacity to choose therapy for a specific individual should be based on some selection,” said Sandy Srinivas, MD.

Putting Precision Medicine into Practice using Genomic Markers

Moreover, In the treatment of prostate cancer, precision medicine is not a new notion. “One of the very first precise techniques of targeting cancer was targeting the androgen receptor (AR),” Alicia K. Morgans, MD, MPH, explained. Although ADT remains the cornerstone of treatment for this patient group. For instance, A number of new targets have emerged in recent years, including. BRCA2 mutations and tumor mutational burden or micro-satellite instability (MSI) both of which can be targeted with. PARP inhibitors and pembrolizumab (Keytruda), respectively.

In addition, The problem with these actionable targets is that they are found in just a small percentage of prostate cancer patients.

The prevalence of germline or somatic. Therefore, BRCA2 mutations in prostate cancer has ranged from. 5.3 percent to 13 percent in studies examining the frequency of BRCA mutations. 1 MSI-high tumors are extremely rarer, with investigators revealing that only 3.1 percent of patients have this actionable target. 2

“I haven’t yet [met] a patient [with prostate cancer] who has MSI-high [disease],” Srinivas said, adding that she checks for this marker in patients who need treatment after AR therapy but aren’t excellent candidates for chemotherapy. “I’ve obviously looked at earlier tissue and liquid biopsies at that time…. This is the time to seek for these markers because patients who have them will have such an amazing therapy choice, one that could result in a longer-lasting response.”

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