AJMP2502 - CME/CMLE - A pathologist’s primer on implementing new standard of care molecular biomarker testing for precision prostate cancer management-A pathologist’s primer on implementing new standard of care molecular biomarker testing for precision prostate cancer management

A pathologist’s primer on implementing new standard of care molecular biomarker testing for precision prostate cancer management

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The article delves into the evolving role of pathologists in the realm of prostate cancer, focusing on the implementation of molecular biomarker testing as an integral part of precision management strategies. Key points include the use of multigene testing on both germline and somatic DNA for prostate cancer patients. The testing primarily targets mutations in homologous recombination repair genes, such as BRCA1/2, which are pivotal for determining the suitability of PARP inhibitors—a class of drugs effective against metastatic, castration-resistant prostate cancer.<br /><br />The narrative highlights the increased responsibilities of pathologists as stewards of tissue samples, integrating histologic and molecular findings in patient management. The article references the shift in pathology practices since the FDA's 2017 histology-agnostic drug approval policy, which has significantly influenced surgical pathology and introduced a new era of tissue stewardship.<br /><br />With regards to prostate cancer specifically, current guidelines recommend extensive molecular testing for patients, with a focus on genes like BRCA1/2 and related pathways that can influence the eligibility for targeted treatments such as PARP inhibitors. The testing process involves methods like next-generation sequencing and is essential for effective treatment planning, particularly for advanced or metastatic cases.<br /><br />The discussion also broaches the predictive and prognostic capacities of these tests, emphasizing the growing evidence for better outcomes through personalized medicine approaches, including PARP inhibitors and potential implications for both platinum-based and conventional therapies. The expanding role of genetic counseling and germline testing is also addressed, noting its significance for both patient management and familial risk assessment.<br /><br />In summary, this article portrays a comprehensive overview of the enhancements in prostate cancer treatment strategies, underscoring molecular testing's role in revolutionizing personalized patient care and the broader implications for pathologists within interdisciplinary medical teams.

Keywords

prostate cancer

pathologists

molecular biomarker testing

precision management

BRCA1/2 mutations

PARP inhibitors

next-generation sequencing

personalized medicine

genetic counseling

tissue stewardship