Evaluating the Impact of Genetic Mutations on Prostate Cancer Survival Rates

Rohan Garje, MD, chief of genitourinary oncology at the Miami Cancer Institute, provides an overview of a study evaluating how mutations, including TP53, RB1, and PTEN, impact overall survival in patients with metastatic prostate cancer.

The study used extensive real-world samples from community oncology centers across the Guardian Research Network. A total of 350 patients with metastatic prostate cancer were identified with 140 enrolled in the biomarker-positive group and 210 in the biomarker-negative group of the multicenter study.

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0:09 | This was a collaboration with Guardian Research Network, which has data from multiple community-based oncology centers, and this study is focusing on prostate cancer where we explored their database to see if alterations and specific mutations have an impact on survival in patients with metastatic prostate cancer. It is a database which involves several organizations where we identified patients with metastatic prostate cancer and genetic testing.

0:54 | One of the biggest limitations currently with prostate cancer management is we do not have risk stratification based on the patient's genomic alterations. In this sense, for anyone with metastatic prostate cancer, our way of identifying high-risk or low-risk populations is based on whether they have high-volume disease or low-volume disease, either they have de novo metastatic disease or metachronous presentation. These are all good classifiers, and they are easy to obtain parameters, but they do not consider the patient's inherent genomics, the molecular alterations that are driving the cancer.

1:40 | We have a lot of information from the multiple studies that have been done [showing] that all [patients with] prostate cancer do not behave the same, and the genomic markers that drive the cancer critical. We know about mutations, specifically BRCA1 and BRCA2, which are not only prognostic, but also predictive of specific treatments, that patients will benefit with [poly-ADP ribose polymerase (PARP)] inhibitors in that situation.

2:14 | In this particular project, what we looked at was other alterations in the more common alterations which we see in prostate cancer, which is the TP53 mutation, RB1, or PTEN, to see if any 1 of these or a combination of these mutations, if they are present, how do they impact patients compared [with] patients who do not have these mutations?