Genetic Testing For Prostate Cancer – Dr. David Samadi Comments on New Prostate Cancer Foundation Study

A ground-breaking new study published by the Prostate Cancer Foundation (PCF) last week, reported that one in nine (12%) men with metastatic prostate cancer carry inherited mutations in DNA damage repair (DDR) genes that most likely caused their disease.

It’s estimated more than 12,000 United States families who’ve experienced prostate cancer have children and grandchildren who are carriers for the DDR genes, according to Jonathan W. Simons, MD, president and CEO of the Prostate Cancer Foundation.

“These findings are a game-changer for opening up the door for men with metastatic prostate cancer and I wholeheartedly agree that all men found to have these mutations should have genetic testing,” said Dr. David Samadi. “This could revolutionize how we identify and treat men with this aggressive cancer.”

The study’s findings suggest all metastatic prostate cancer patients be encouraged to obtain genetic testing. Genetic testing helps identify men at greatest risk and if found to be positive, family members would be encouraged to seek genetic counseling also.

This research mirrors when specific inherited mutations in BRCA1 and BRCA2 were found to increase the risk of female breast and ovarian cancers. Discovered in the PCF study were defects in BRCA2, representing 44% of all identified mutations, with the mutation occurring most frequently in men with advanced prostate cancer.

“What I find extremely encouraging from this study is how I will be able to recommend specific targeted treatment for these men,” exclaimed Dr. Samadi. “Several new medications appear to be effective for this type of prostate cancer.”

A fairly new class of drugs known as PARP inhibitors is one treatment possibly benefitting prostate cancer patients with DDR mutations. One PARP inhibitor approved earlier this year for the treatment of advanced prostate cancer is called Olaparib. Olaparib was originally developed to treat women with inherited cancers and was initially approved for the treatment of BRCA-mutated ovarian cancer in 2014.

Another possible treatment to eradicate DDR-mutated tumors is platinum chemotherapy such as cisplatin and carboplatin.

Since DDR defects in the general population is relatively rare, widespread implementation of genetic screening for all men is not recommended nor is it recommended for men with localized, low-intermediate risk prostate cancer unless they have a strong family history of prostate, breast, or other cancers.

According to Dr. Samadi, “This is some of the best news yet for these men with this inherited mutation, providing hope for beating back this form of prostate cancer. Determination of genetic testing of other male relatives of their family will have to be done on an individual basis depending on the presences of hereditary mutations. We don’t want to scare male relatives who may carry this gene to believe they may have to undergo radical treatments possibly affecting their quality of life. Instead the right course is to offer more intensive screenings for these men starting at a younger age while regularly keeping tabs on them throughout their life.”

Patients newly diagnosed with prostate cancer can contact world renowned prostate-cancer surgeon and urologic oncologist, Dr. David Samadi, for a consultation and to learn more about prostate cancer risk; call 212-365-5000.