Importance of Molecular Testing in Prostate Cancer

Adam Weiner, MD, chief urology resident at Northwestern University in Chicago, discusses the importance of molecular testing for prostate cancer and what the current targeted therapy landscape looks like for this disease.

Prostate cancer has been subclassified based on molecular drivers. However, utility remains limited due to the reliance on multi-omics and cost and while commercial products have been widely used for this implication, they do not subclassify prostate cancer regarding molecular subtypes.

Since there are no studies which aim to create a prostate-specific model based on cell-of-origin, Weiner et al developed and validated an RNA expression-based prostate cancer subtyping classifier for cell-of-origin expression patterns which was created with the help of the originators of the GRID cohort (NCT02609269). Two cohorts were examined, including a training cohort which consisted of 32,000 patients and a validation cohort of 68,547 patients.

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0:08 | Currently, there are many commercial products out there that can help us prognosticate prostate cancer and they're certainly adding to our ability to personalize prostate cancer management. At this point, we're still working towards a perfect subtyping mechanism for prostate cancer that can really distill what treatment makes sense for which patients. I think right now we have great tests that can help us determine the aggressiveness of prostate cancer or who needs to be monitored more closely, but we're still working on a great subtyping mechanism to figure out how we can personalize treatment.

0:49 | There is a lot of research out there that has looked at subtypes of prostate cancer, though in large part, it's been limited in terms of its ability to be applied clinically, and that's for many reasons. They use a multi-omics approach that might not be available on a wide enough scale, or the cost might not be something that can be incurred by all the patients in the providers. We are still looking for something that can be applied more broadly.