Journal article
Clinician-Reported Management Recommendations in Response to Universal Germline Genetic Testing in Patients With Prostate Cancer
The Journal of urology, v 212(6)
09 Aug 2024
PMID: 39121056
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Identification of pathogenic germline variants in patients with prostate cancer can help inform treatment selection, screening for secondary malignancies, and cascade testing. Limited real-world data are available on clinician recommendations following germline genetic testing in patients with prostate cancer.
Patient data and clinician recommendations were collected from unselected patients with prostate cancer who underwent germline testing through the PROCLAIM trial. Differences among groups of patients were determined by 2-tailed Fisher's exact test with significance set at
< .05. Logistic regression was performed to assess the influence of test results in clinical decision-making while controlling for time of diagnosis (newly vs previously diagnosed).
Among 982 patients, 100 (10%) were positive (
1 pathogenic germline variant), 482 (49%) had uncertain results (
1 variant of uncertain significance), and 400 (41%) were negative. Patients with positive results were significantly more likely than those with negative or uncertain results to receive recommendations for treatment changes (18% vs 1.4%,
< .001), follow-up changes (64% vs 11%,
< .001), and cascade testing (71% vs 5.4%,
< .001). Logistic regression demonstrated that positive and uncertain results were significantly associated with both changes to treatment and follow-up (
< .001) when controlling for new or previous diagnosis.
Germline genetic testing results informed clinical recommendations for patients with prostate cancer, especially in patients with positive results. Higher than anticipated rates of clinical management changes in patients with uncertain results highlight the need for increased genetic education of clinicians treating patients with prostate cancer.
Metrics
Details
- Title
- Clinician-Reported Management Recommendations in Response to Universal Germline Genetic Testing in Patients With Prostate Cancer
- Creators
- Neal Shore - Carolina Urologic Research CenterChristopher Pieczonka - SUNY Upstate Medical UniversitySean Heron - Advanced Urology Institute, St Petersburg, FloridaMukaram Gazi - Urology AssociatesDavid Cahn - Colorado Urology, Lakewood, ColoradoLaurence H Belkoff - MidLantic Urology, Bala Cynwyd, PennsylvaniaAaron Berger - Dermatology SpecialistsBrian Mazzarella - Urology Austin, Austin, TexasJoseph Veys - Georgia UrologyCharles Idom - Georgia UrologyDavid Morris - Urology AssociatesGautam Jayram - Urology AssociatesAlexander Engelman - Florida Urology Partners, Cancer Center of South Tampa, St Petersburg, FloridaPaul Dato - Genesis HealthCareRichard Bevan-Thomas - Urology Partners, Arlington, TexasDavid R Wise - NYU Langone HealthMary Kay Hardwick - Invitae (United States)Susan Rojahn - Invitae (United States)Paige Layman - Invitae (United States)Brandie Heald - Invitae (United States)Rachel E Ellsworth - Invitae (United States)Kathryn E Hatchell - Invitae (United States)Robert L Nussbaum - Invitae (United States)Sarah M Nielsen - Invitae (United States)Edward D Esplin - Invitae (United States)
- Publication Details
- The Journal of urology, v 212(6)
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Number of pages
- 12
- Grant note
- Invitae
We thank all of the patients for their participation.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001361544800010
- Scopus ID
- 2-s2.0-85202011320
- Other Identifier
- 991021916912204721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology