Consensus Conference Offers Guidance on Germline Testing for Prostate Cancer
Posted: Wednesday, August 12, 2020
Key recommendations from the 2019 Philadelphia Prostate Cancer Consensus Conference were recently published in the Journal of Clinical Oncology. Convened to address the gaps and challenges in implementing genetic testing for prostate cancer, the conference suggested that all men with prostate cancer be tested, especially those with a family history of the disease. Leonard G. Gomella, MD, of Thomas Jefferson University, Philadelphia, and colleagues also noted BRCA1, BRCA2, and ATM were priority genes to be tested to better inform precision medicine and clinical trial eligibility.
The conference included 97 participants from different medical fields, patient stakeholders, and members of national organizations. They used evidence review to inform questions using the modified Delphi model and cast anonymous votes using a Web-based polling platform. The final framework included criteria with strong (greater than 75%) agreement, moderate (50%–74%) agreement, and 50% agreement for lack of consensus.
The final framework revealed the strongest consensus for large germline panels and somatic testing, reflex testing (initial testing of priority genes followed by expanded testing) along with testing for patients with a family history suggestive of hereditary prostate cancer. Additional family history and pathologic criteria garnered moderate consensus.
The recommendations for priority genes included BRCA2, BRCA1, and mismatch repair genes. Also, broader testing should include ATM for clinical trial eligibility. Furthermore, the participants indicated that screening should start at age 40 or 10 years before the youngest prostate cancer diagnosis in a family with BRCA2 carriers. They also recommended collaborative (point-of-care) evaluation models between health-care and genetic providers to address the genetic counseling shortage.
Dr. Gomella and colleagues concluded: “This multidisciplinary…framework provides novel guidance to clinicians and patients tailored to the precision era. Multiple research, education, and policy needs remain of importance.”
Disclosure: For full disclosures of the study authors visit, ascopubs.org.