Multitumor | Genomic Assays in the “Real” Oncology World — Part 2: Exploring the Role of Genomic Testing in Guiding Treatment for Patients with Advanced Breast, Colorectal and Prostate Cancers

published 1 week ago by Dr Neil Love

Genomic Assays in the “Real” Oncology World — Part 2: Genomic Assays in Prostate and Breast Cancer — Featuring a roundtable discussion with Drs Emmanuel S Antonarakis, Johanna Bendell, Ian E Krop and Andrew McKenzie. NGS for Metastatic Prostate Cancer (mPC) and the Potential Clinical Significance of Genomic Alterations Genetic alterations assessed in routine practice, including MSI status, BRCA mutations and AR-V7 variants; role of multiplex testing Presentation (Dr Antonarakis): Biomarker assessment in mPC; detection of DNA damage repair abnormalities and prediction of benefit with PARP and PD-1 inhibitors Landscape of DNA damage repair mutations in newly diagnosed and metastatic prostate cancer Rationale for the use of PARP inhibitors for prostate cancer with BRCA or ATM mutations Genetic testing of primary and metastatic tumors for alterations in the DNA repair and androgen receptor (AR) signaling pathways Clinical significance and genetic detection of AR splice variants Results of the CARD trial: Cabazitaxel versus enzalutamide or abiraterone for patients with mCRPC previously treated with docetaxel who experience rapid disease progression on an AR-targeted agent Efficacy of olaparib for mCRPC Available data with rucaparib, niraparib and talazoparib for mCRPC Role of radium-223 dichloride for patients with mPC; novel combination approaches with radium-223 under investigation Sensitivity of BRCA1, BRCA2 and ATM mutations to PARP inhibitors Activity of PARP inhibitors in patients with breast, ovarian, prostate and pancreatic cancers with BRCA mutations Homologous recombination deficiency and response to PARP inhibitors Case (Dr Antonarakis): A man in his mid-40s with mCRPC and a BRCA2 mutation attains a complete response to olaparib Case (Dr Antonarakis): A man in his mid-60s diagnosed with de novo mPC and MSI-high status, high tumor mutation burden and an MSH2 mutation experiences an excellent response to pembrolizumab after multiple lines of therapy Association of ductal and intraductal prostate cancer with a high prevalence of DNA damage repair gene mutations Predictors of benefit with immune checkpoint inhibitors Multigene Testing and Detection of Genomic Alterations in Metastatic Breast Cancer (mBC) Role of MSI testing and multiplex genomic assays in mBC Assessment of PIK3CA and BRCA mutations and assays for ESR1 Presentation (Dr Krop): Biomarker assessment in mBC — ER-positive and triple-negative disease PTEN loss and implications for therapeutic decision-making for mBC ESR1 mutations and resistance to hormone therapy Efficacy of PARP inhibitors in patients with BRCA mutations HER2 expression in HER2 nonamplified cancers; activity of trastuzumab deruxtecan in HER2-low breast cancer PD-L1 and other biomarkers predictive of benefit from immunotherapy in triple-negative breast cancer (TNBC) Case (Dr Krop): A woman in her late 50s with de novo TNBC receives atezolizumab/nab paclitaxel as first-line therapy Case (Dr Krop): A woman in her early 60s with ER-positive, HER2-negative mBC and a germline BRCA2 mutation whose disease progresses through multiple therapies attains a partial response to olaparib The Sarah Cannon Experience with Molecular Tumor Boards The use of molecular tumor boards to review molecular profiling data and facilitate therapeutic decision-making CME information and select publications

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