Personalized Medicine Makes Strides Across the GU Oncology Treatment Space

Patients with genitourinary cancers such as kidney, bladder or prostate cancer should ask their doctor about precision medicine, which tailors treatment based on genetic testing, according to Dr. Chandler Park.

For example, some patients with kidney cancer with specific gene mutations may benefit from targeted therapy, while those with stage 4 bladder cancer should check for FGFR3 or HER2 mutations to see if they qualify for more effective treatments. In prostate cancer, genetic testing for BRCA and other mutations can help guide treatment choices. In an interview with CURE®, Park discusses the importance of genetic testing and personalized medicine, as this approach ensures patients receive the most effective and personalized care.

Park is a medical oncologist of Genitourinary Medical Oncology, at the Norton Healthcare Institute, in Louisville, Kentucky.

Transcript:

One of the things about genitourinary cancers is every patient — whether you have kidney cancer, bladder cancer or prostate cancer — needs to be evaluated for precision medicine. This is something I would share with my patients and their family members: ask for precision medicine. For example, let's say a patient has kidney cancer and they have specific gene mutations, such as von Hippel Lindell (VHL) germline mutations. If they do, I would consider them for evaluation by a genetic counselor to see if they have a condition called von Hippel Lindell disease, and in the future, I would consider them for treatment with a medication called Welireg [belzutifan]; that's a precision medicine now.

In bladder cancer… there has been an explosion of precision medicine. There are three highlights that I would talk about with somebody with bladder cancer to chat with their oncologist about. First — specifically in stage 4 disease — do I have a gene mutation? Do I have a gene mutation called FGFR3, because if you do, you can receive a medication called Balversa [erdafitinib]. [This agent] has a strong 40% to 45% response rate and is better than chemotherapy. The second thing that's emerged in the last six months is asking your oncologist, if you have a gene mutation called HER2. HER2 is something that oncologists know in terms of the breast cancer world, but if a patient has stage 4 bladder cancer and they have a HER2 gene mutation, there's a 60% to 65% chance that if they receive a medication called Enhertu [fam-trastuzumab deruxtecan-nxki], that it would work. I would ask if they have a HER2 gene mutation.

In terms of prostate cancer and precision medicine, we have to check for BRCA1, BRCA2, PALB2, CDK12, [and others]. I would ask, in terms of, when you see the oncologist, whether you have prostate, kidney or bladder cancer, ask that oncologist about the role of precision medicine and the role of next-generation sequencing. This way, you are or your family member is receiving, precision medicine, which is the best treatment for their specific cancer.

Transcript has been edited for clarity and conciseness.

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