Why Germline Testing is Important for Patients with Prostate Cancer

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Undergoing germline testing is of particular importance for patients with prostate cancer, as one expert explained.

“Germline testing is that genetic testing of the of the sequence of DNA that you inherit from your parents, so it's looking at whether you've inherited your risk for cancer,” explained Dr. Kelly Stratton, associate professor of urologic oncology at the University of Oklahoma in Oklahoma City, during a conversation that was part of the CURE® “Speaking Out” video series.

“In prostate cancer, that's particularly important because it could allow us to give you treatments that can be targeted to alterations that you've inherited and may have been what predisposed you to develop prostate cancer.”

Many patients with high-risk or metastatic (cancer that has spread to other parts of the body) prostate cancer are recommended to undergo germline testing, for example, Stratton said.

“A lot of times urologist can be the point person for referring or conducting that testing, and that testing can also help us identify patients who may be candidates for other treatments,” Stratton said. “In particular, for patients who have metastatic, castration-resistant prostate cancer [cancer that grows when testosterone levels in the body are low], there are several drugs that are specifically indicated for patients who have [genetic] alterations.”

However, adherence to germline testing is low. A study published in JAMA in 2023 found that, among nearly 1.4 million patients who received a diagnosis of cancer between 2013 and 2019 in California and Georgia, only 6.8% in total underwent germline testing, and only 1.1% of patients who received a diagnosis of prostate cancer were tested.

“Historically, there have been a lot of a lot of barriers, both understanding the potential candidates for testing, understanding the test and how they're available, and also the potential cost to patients,” Stratton said. “As we continue to get more and more treatment options, I think those barriers have gone down, urologists are increasingly more comfortable referring or conducting the genetic testing, insurance companies are understanding the benefit of approving those tests and it's easier for us to communicate to patients the potential implications of the genetic test, and also the costs of the genetic tests. So, as we see more and more treatments, it becomes an easier conversation to have with patients.”

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