Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review
New classification systems based on molecular features have been introduced to improve precision medicine for prostate cancer (PCa). This review covers the increasing risk of PCa and the differences in response to targeted therapy that are related to specific gene variations. We believe that genomic...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S228788822030057X |
| _version_ | 1797704965872943104 |
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| author | Jae-Seung Chung Todd M. Morgan Sung Kyu Hong |
| author_facet | Jae-Seung Chung Todd M. Morgan Sung Kyu Hong |
| author_sort | Jae-Seung Chung |
| collection | DOAJ |
| description | New classification systems based on molecular features have been introduced to improve precision medicine for prostate cancer (PCa). This review covers the increasing risk of PCa and the differences in response to targeted therapy that are related to specific gene variations. We believe that genomic evaluations will be useful for guiding PCa risk stratification, screening, and treatment. We searched the PubMed and MEDLINE databases for articles related to genomic testing for PCa that were published in 2020 or earlier. There is increasing evidence that germline mutations in DNA repair genes, such as BRCA1/2 or ATM, are closely related to the development and aggressiveness of PCa. Targeted prostate-specific antigen screening based on the presence of germline alterations in DNA repair genes is recommend to achieve an early diagnosis of PCa. In cases of localized PCa, even if it has a favorable risk classification, patients under active surveillance with these gene alterations are likely to develop aggressive PCa. Thus, active treatment may be preferable to active surveillance for these patients. In cases of metastatic castration–resistant PCa, BRCA1/2 and DNA mismatch repair genes may be useful biomarkers for predicting the response to androgen receptor–targeting agents, poly (ADP-ribose) polymerase inhibitors, platinum chemotherapy, prostate-specific membrane antigen–targeted therapy, immunotherapy, and radium-223. Genomic evaluations may allow for risk stratification of patients with PCa based on their molecular features, which may help guide precision medicine for treating PCa. |
| first_indexed | 2024-03-12T05:28:15Z |
| format | Article |
| id | doaj.art-019a06a8aa674d1b88c20363e59a0e2b |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T05:28:15Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-019a06a8aa674d1b88c20363e59a0e2b2023-09-03T07:00:47ZengElsevierProstate International2287-88822020-09-018399106Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative reviewJae-Seung Chung0Todd M. Morgan1Sung Kyu Hong2Department of Urology, Inje University Haeundae Paik Hospital, Busan, KoreaDepartment of Urology, University of Michigan, Rogel Cancer Center, Ann Arbor, MI, USADepartment of Urology, Seoul National University College of Medicine, Seoul, Korea; Department of Urology, Seoul National University Bundang Hospital, Seongnam-si, Korea; Corresponding author. Department of Urology, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, Gyunggido, 463-707, Korea.New classification systems based on molecular features have been introduced to improve precision medicine for prostate cancer (PCa). This review covers the increasing risk of PCa and the differences in response to targeted therapy that are related to specific gene variations. We believe that genomic evaluations will be useful for guiding PCa risk stratification, screening, and treatment. We searched the PubMed and MEDLINE databases for articles related to genomic testing for PCa that were published in 2020 or earlier. There is increasing evidence that germline mutations in DNA repair genes, such as BRCA1/2 or ATM, are closely related to the development and aggressiveness of PCa. Targeted prostate-specific antigen screening based on the presence of germline alterations in DNA repair genes is recommend to achieve an early diagnosis of PCa. In cases of localized PCa, even if it has a favorable risk classification, patients under active surveillance with these gene alterations are likely to develop aggressive PCa. Thus, active treatment may be preferable to active surveillance for these patients. In cases of metastatic castration–resistant PCa, BRCA1/2 and DNA mismatch repair genes may be useful biomarkers for predicting the response to androgen receptor–targeting agents, poly (ADP-ribose) polymerase inhibitors, platinum chemotherapy, prostate-specific membrane antigen–targeted therapy, immunotherapy, and radium-223. Genomic evaluations may allow for risk stratification of patients with PCa based on their molecular features, which may help guide precision medicine for treating PCa.http://www.sciencedirect.com/science/article/pii/S228788822030057XCastration resistantGenetic testingProstate cancerProstatic neoplasmsScreeningTreatment |
| spellingShingle | Jae-Seung Chung Todd M. Morgan Sung Kyu Hong Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review Prostate International Castration resistant Genetic testing Prostate cancer Prostatic neoplasms Screening Treatment |
| title | Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review |
| title_full | Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review |
| title_fullStr | Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review |
| title_full_unstemmed | Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review |
| title_short | Clinical implications of genomic evaluations for prostate cancer risk stratification, screening, and treatment: a narrative review |
| title_sort | clinical implications of genomic evaluations for prostate cancer risk stratification screening and treatment a narrative review |
| topic | Castration resistant Genetic testing Prostate cancer Prostatic neoplasms Screening Treatment |
| url | http://www.sciencedirect.com/science/article/pii/S228788822030057X |
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