Germline pathologic mutations and cancer family history in prostate cancer patients.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 378-378
Author(s):  
Marcus Marie Moses ◽  
Elisa Ledet ◽  
Emma M. Ernst ◽  
Patrick Cotogno ◽  
Joshua Schiff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
San Francisco ◽  
Treatment Options ◽  
Distant Metastases ◽  
Cancer Center ◽  
Chi Square ◽  
Variant Of Uncertain Significance ◽  
Pathogenic Variants ◽  
Uncertain Significance

378 Background: Prostate cancer (PCa) patients (pts) with metastases and/or strong family history (FH) of cancer (Ca) are at higher risk of a germline mutation. The identification of alterations in PCa pts may be important for risk stratification as well as personalizing treatment options. The goal of this study was characterization of FH and pathogenic variants (PV) detected in PCa pts, with both localized and metastatic disease. Methods: 300 PCa pts from Tulane Cancer Center underwent germline testing. 265 Caucasian (C) and 35 African-Americans (AA) were tested and met the NCCN criteria for testing and/or had distant metastases (mets). Germline genetic testing was done via commercial panels (30-80 genes) (Invitae. San Francisco, Ca). PCa pts had extensive FH screening. Clinical annotation included age at diagnosis (dx), race, and presence of mets at any time. Chi square tests were used to compare clinical correlates and PVs. Results: Of the 300 pts tested, 182 pts (60.6%) had mets and 118 (39.4%) did not. 41 pts (13.6%) had ≥ 1 germline pathogenic variant (PV) and 161 pts (53.6%) had ≥ 1 germline variant of uncertain significance (VUS). PVs were detected in BRCA2 (n = 10), MUTYH (n = 8), CHEK2 (n = 6), BRCA1 (n = 4), ATM (n = 4), TP53 (n = 3), PMS2 (n = 2), BLM (n = 2), MITF (n = 2), NBN (n = 1), and RAD51D (n = 1). MUTYH and MITF are not known to be linked to prostate cancer. There was no significant relationships in FH PCa and FH non-PCa in regard to likelihood of a PV (p = .86 and p = .18). Of the 300 pts tested, 136 pts (45.3%) had PCa FH, 131 pts (43.6%) had breast Ca FH, 61 pts (20.3%) had lung Ca FH, 61 pts (20.3%) had colon Ca FH, 37 pts (12.3%) had pancreatic Ca FH, and 32 pts (10.6%) had ovarian Ca FH. 45.6% of C men (n = 121) and 42.8% of AA men (n = 15) had PCa FH. Pts with a non-PCa FH (n = 255) were 1.37 times more likely to develop mets (p = .01168). The median age of dx were 61 for PV pts, 62 for VUS pts, and 61 for negative pts (non-significant). 21/182 pts with mets (11.5%) had a PV; 8/182 (4.4%) pts with mets had a BRCA2 PV. Conclusions: In metastatic patients, FH of prostate cancer alone cannot predict those with PV. The most common Cas observed in these pts were breast, lung, colon and pancreatic. A larger cohort is needed to fully characterize and understand the co-segregation of PCa with other Cas.

Germline variants and family history in caucasian and African-American prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16548-e16548
Author(s):  
Elisa M. Ledet ◽  
Emma M. Ernst ◽  
Joshua Schiff ◽  
Shuwen Lin ◽  
Brian E. Lewis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Genetic Testing ◽  
Family History ◽  
San Francisco ◽  
Testing Methods ◽  
Chi Square ◽  
Genetic Studies ◽  
Pathogenic Variants ◽  
Unknown Significance

e16548 Background: Family history (FH) is a well-documented risk factor for prostate cancer (PCa). Previously, germline pathogenic variants (PVs) have been identified in metastatic PCa. The goal of this study was to fully evaluate cancer FH and assess PVs detected in PCa patients undergoing both detailed FH ascertainment and germline genetic testing. Methods: FHs were collected from 535 PCa pts (Caucasian (Ca) n = 359, African American (AA) n = 85, Other n = 18) at Tulane from 2015-2016. Age at diagnosis, Gleasons, and the presence of metastases at any time were noted for these pts. Chi-square and the Mann-Whitney U tests were performed to identify relationships between clinical parameters and FH. 124 PCa pts including those with both localized and metastatic disease were identified with FHs that met guidelines for genetic testing. Genetic testing was done using a commercially available panel (Invitae, San Francisco, CA) of 25-79 cancer-related genes for mutations/selected exon deletions/duplications. Results: Of the 124 tested pts, 20 pts (16.1%) had ≥ 1 germline PV and 47 pts (37.9%) had ≥ 1 germline variant unknown significance. PVs included: BRCA2 (n = 4), BRCA1 (n = 3), CHEK2 (n = 3), MUTYH (n = 3), ATM (n = 2), TP53 (n = 1), MITF (n = 1), NBN (n = 1), PMS2 (n = 1), and RAD51D (n = 1). No PVs were detected in AA pts (n = 20). 435 of 535 PCa pts (81.3%) had a cancer FH with prostate (37.8%), breast (28.2%), lung (16.4%), colorectal (14.8%), and pancreatic (7.5%) cancer being most common. 281 pts (52.5%) had ≥ 2 relatives with cancer. Pts with PCa FH were more likely to be dx age ≤ 55 (p = 0.017). Median age was younger at dx for pts with PCa FH (p = 0.0005). PCa FH did not alter Gleason or metastatic rate. FH influenced age at dx for Ca men (p = 0.0009, 58 vs. 62.5 and Ca men with PCa FH) were 1.55x more likely to develop metastases (p = 0.035). In AA pts, there were no significant associations between FH, and metastases or age at dx. Conclusions: The most prevalent germline mutations in this cohort were in DNA repair pathway genes. Pts with PCa FH were younger at dx than those without PCa FH. Further studies are needed to understand the co-segregation of PCa with other cancers and genetic studies are needed to clarify the mechanisms of these trends which may differ between Ca and AA men.

Inherited pathologic mutations and family history in patients with prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 185-185
Author(s):  
Shuwen Lin ◽  
Elisa M. Ledet ◽  
Joshua Schiff ◽  
Emma M. Ernst ◽  
Cathryn E. Garvey ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Ovarian Cancer ◽  
Dna Repair ◽  
Genetic Testing ◽  
Family History ◽  
San Francisco ◽  
Metastatic Disease ◽  
Cancer Center ◽  
Pathogenic Variants ◽  
Significant Difference

185 Background: In prostate cancer (PCa), germline pathogenic variants have previously been underestimated. PCa patients (pts) with DNA repair defects have a higher percentage of non-PCa family history (FH) with the most common cancers being derived from the breast, GI tract, ovary, pancreas, lymphoma/leukemia. The goal of this study was to evaluate and characterize pathogenic variants detected in PCa patients undergoing both enhanced FH screening and genetic testing. Methods: In this single-institution study, 535 PCa pts from Tulane Cancer Center over the last year underwent enhanced FH screening, and FH of PCa and other cancers were collected. 124 PCa pts including those with both localized and metastatic disease were identified to have a FH that met NCCN guidelines for genetic testing. Genetic testing was done using a commercially available panel (Invitae, San Francisco, CA) of 25-79 cancer-related genes for mutations and selected exonic deletions/duplications. Results: Of the 124 tested pts, 21 pts (16.9%) had ≥ 1 germline pathogenic variant (PV) and 47 pts (37.9%) had ≥ 1 germline variant of unknown significance (VUS). PVs included: BRCA2 (n = 4), BRCA1 (n = 3), CHEK2 (n = 3), MUTYH (n = 3), ATM (n = 2), TP53 (n = 2), MITF (n = 1), NBN (n = 1), PMS2 (n = 1), and (RAD51D (n = 1). Of the 124 tested pts, 68 pts (54.8%) had PCa FH, 68 (54.8%) had breast cancer FH, 22 (17.7%) had pancreatic cancer FH, 16 (12.9%) had ovarian cancer FH, and 37 (29.8%) had both breast and PCa FH. Between the pt groups (those with PVs, VUSs and negative results), there were no differences in FH rates of PCa, breast, pancreatic, or ovarian cancer. There was no significant difference in the age at diagnosis (dx) between the groups or between pts with PCa FH and those without. The median ages at dx were 65 for PV pts, 60 for VUS pts, and 59 for negative result pts. There were no statistically significant differences in initial Gleason score or metastatic disease status in these three groups (p = 0.35 and p = 0.66). Conclusions: In this dataset, FH cannot discriminate between those with and without inherited PV using a broad panel of genes that include those that alter DNA repair. The implications of these findings are broad. [Table: see text]

Family history, race, and prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 225-225
Author(s):  
Joshua Schiff ◽  
Elisa M. Ledet ◽  
Emma M. Ernst ◽  
Cathryn E. Garvey ◽  
Patrick Cotogno ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Gleason Score ◽  
Cancer Center ◽  
Clinical Factors ◽  
Degree Relative ◽  
Chi Square ◽  
Clinical Correlates ◽  
Incidence And Mortality ◽  
N 93

225 Background: African American (AA) race and family history (FH) of prostate cancer (PCa) increase the incidence and mortality of PCa. The goal of this study was to assess and compare FH in AA and Caucasian (C) men. Methods: During June 2015 through September 2016, 338 men with prostate cancer had FH collected at Tulane Cancer Center (C = 266 and AA = 72). A FH was defined as ≥ 1 1st degree relative with PCa and/or ≥ 2 affected 2nd/3rddegree relatives. Documented clinical factors were age at diagnosis (dx), Gleason score, incidence of radical prostatectomy (RP), and presence of metastases (at any time). Chi-square and Mann-Whitney U tests were performed to identify potential clinical correlates with regard to FH and race. Results: For demographics see table below. On average, men with a FH of PCa (n = 110) had a median age at dx of 59.6 as compared to those without a FH of PCa (n = 151) (median age at dx = 63.0). Overall FH patients (pts) were younger at dx (p = 0.00046). FH had a particularly impactful influence upon the age at dx for C men (p = 0.00086, 58 [n = 88] vs. 62.5 [n = 112]); statistics were limited for AA men. Gleason scores were not different between pts with or without a FH, and there was no relationship between Gleason score and race. Metastatic disease (mets) was detected in 23.97% of men (n = 93). C men with a FH of PCa (n = 40) were 1.55 times more likely to develop mets (p = 0.0352). AA data were limited so no comment can be made. No relationship was detected between the pts having undergone a RP and race, but pts with a FH of PCa (n = 61) were 1.39 times more likely to have undergone surgery (p = 0.016). Data by racial subsets were too limited to be conclusive. Conclusions: The study highlighted the significant impact that FH of PCa has upon age at dx and presence of mets. More AA data are needed to be conclusive. [Table: see text]

scholarly journals Revealing the Mutational Spectrum in Southern Africans With Amyotrophic Lateral Sclerosis

2022 ◽  
Vol 8 (1) ◽  
pp. e654
Author(s):  
Melissa Nel ◽  
Amokelani C. Mahungu ◽  
Nomakhosazana Monnakgotla ◽  
Gerrit R. Botha ◽  
Nicola J. Mulder ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Population Group ◽  
Genetic Ancestry ◽  
Familial Case ◽  
Data Sets ◽  
Variant Of Uncertain Significance ◽  
Pathogenic Variants ◽  
Sporadic Als ◽  
Uncertain Significance ◽  
Lateral Sclerosis

Background and ObjectivesTo perform the first screen of 44 amyotrophic lateral sclerosis (ALS) genes in a cohort of African genetic ancestry individuals with ALS using whole-genome sequencing (WGS) data.MethodsOne hundred three consecutive cases with probable/definite ALS (using the revised El Escorial criteria), and self-categorized as African genetic ancestry, underwent WGS using various Illumina platforms. As population controls, 238 samples from various African WGS data sets were included. Our analysis was restricted to 44 ALS genes, which were curated for rare sequence variants and classified according to the American College of Medical Genetics guidelines as likely benign, uncertain significance, likely pathogenic, or pathogenic variants.ResultsThirteen percent of 103 ALS cases harbored pathogenic variants; 5 different SOD1 variants (N87S, G94D, I114T, L145S, and L145F) in 5 individuals (5%, 1 familial case), pathogenic C9orf72 repeat expansions in 7 individuals (7%, 1 familial case) and a likely pathogenic ANXA11 (G38R) variant in 1 individual. Thirty individuals (29%) harbored ≥1 variant of uncertain significance; 10 of these variants had limited pathogenic evidence, although this was insufficient to permit confident classification as pathogenic.DiscussionOur findings show that known ALS genes can be expected to identify a genetic cause of disease in >11% of sporadic ALS cases of African genetic ancestry. Similar to European cohorts, the 2 most frequent genes harboring pathogenic variants in this population group are C9orf72 and SOD1.

Use of germ-line single nucleotide polymorphisms (SNPs) in drug transporters (ABCG2/ABCB1) and tubulin (TUBB4) to predict survival in patients with metastatic castrate-resistant prostate cancer (CRPC) receiving docetaxel.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 58-58
Author(s):  
N. M. Hahn ◽  
J. Jung ◽  
S. Philips ◽  
Y. R. Patel ◽  
K. A. Carr ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Germ Line ◽  
Treatment Options ◽  
Specific Antigen ◽  
Cancer Center ◽  
Clinical Parameters ◽  
Nucleotide Polymorphisms ◽  
Multiple Treatment ◽  
Castrate Resistant ◽  
Ecog Ps

58 Background: Multiple treatment options now exist for metastatic CRPC patients (pts). Germ-line SNPs in docetaxel (D) transport, metabolism, binding site, and degradation genes may contribute to variability in outcomes observed in D treated CRPC pts. Methods: Between 1/07 and 10/08, all PCa pts seen in the Indiana University Simon Cancer Center oncology clinics were approached for recruitment to the Prostate Cancer Genetic Risk Evaluation of SNPs Study (PROGRESS). Participants completed a demographic and clinical questionnaire and provided a blood sample. Only CRPC pts treated with D were included in this analysis. Germ-line DNA was analyzed for SNP genotyping on a 128-SNP chip using a TaqMan OpenArray GT Kit (Applied Biosystems). The chip included genes critical to D signaling, transport, and elimination with minor allele frequencies > 5%. Pts were followed for progression-free (PFS) and overall survival (OS). Univariable analyses were performed to identify significant associations between SNP genotype, clinical parameters, and PFS and OS outcomes. Results: 60 pts with metastatic CRPC initiated on D enrolled. Demographics included: age (median) – 69 yrs, ECOG PS 0– 40%, prostate specific antigen (PSA) (median) – 129.9 ng/ml, PSA doubling time (median) – 1.8 months, visceral mets –25%. No clinical parameters were associated with PFS and OS. Significant SNP associations are summarized below. Conclusions: Differences in germ-line ABCG2, ABCB1, and TUBB4 SNPs may contribute to variation in clinical outcomes in CRPC pts treated with D. [Table: see text] [Table: see text]

Prevalence of pathogenic germline variants in DNA repair by race, age, and ethnicity in men with prostate cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5062-5062
Author(s):  
Alexandria Mara ◽  
Jason Zhu ◽  
Yuan Wu ◽  
Tom Callis ◽  
Shan Yang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Advanced Prostate Cancer ◽  
Final Analysis ◽  
The United States ◽  
National Study ◽  
Germline Variants ◽  
Variant Of Uncertain Significance ◽  
Race Ethnicity ◽  
Germline Testing

5062 Background: Patients with advanced prostate cancer (PC) frequently harbor pathogenic or likely pathogenic (P/LP) germline variants (GVs) in mismatch repair (MMR) and homologous repair (HR) enzymes which have clinical and treatment implications. However, whether the prevalence of such GVs differ by race, ethnicity, family history, or age is unknown in men with PC. Methods: This is a retrospective analysis of germline DNA from men with PC in the United States, tested by Invitae. Baseline characteristics including self-identified race, ethnicity, family history (FH), and age were recorded. Race and ethnicity were analyzed by 3 cohorts: non-Ashkenazi Caucasian Americans (CA), non-Ashkenazi African Americans (AA), and Ashkenazi Jewish Americans (AJ). Chi-square testing was performed to identify significant differences across these categories between the three cohorts, with respect to combined and individual pathogenic MMR (MSH2/6, MLH1, PMS2, and MUTYH) and HR genes (BRCA1/2, ATM, CHEK2, RAD51D, and PALB2). Results: 3057 men were included in the final analysis: 2248 (74%) men were CA, 229 (7%) were AA, and 210 (7%) were AJ. Of these, 2665 (87%) men had a FH of PC and 463 (15%) had a P/LP GV. In addition, 1068 (35%) were found to have a variant of uncertain significance, and 35 (1.6%) had the HOXB13 G84E variant. There were no significant differences in the overall prevalence of MMR (CA 1.5% vs AA 0.9% vs AJ 1.4%, p = 0.89) or HR genes (CA 7.8% vs AA 7.9% vs AJ 10.5%, p = 0.37) by race/ethnicity. With respect to individual genes, AJ had a higher prevalence of pathogenic BRCA1 alterations (AJ 3.3% vs CA 0.8% vs AA 1.7%, p = 0.0034) and CHEK2 alterations (AJ 4.3% vs CA 2.8% vs AA 0.4%, p = 0.02). There were no significant differences in the prevalence of individual or specific classes of GVs between those with or without a self-reported FH of prostate or breast/ovarian cancers. There was also no association between prevalence of HR genes and age at germline testing (p = 0.40). Conclusions: This national study found that the overall prevalence of pathogenic GVs in MMR and HR genes do not differ by race, ethnicity, or age at the time of testing, and suggests that all men with advanced prostate cancer should be offered germline testing.

Circulating tumor DNA (ctDNA) landscape in metastatic castrate-resistant prostate cancer patients with germline alterations.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 200-200
Author(s):  
Marcus W. Moses ◽  
Peter Steinwald ◽  
Ellen Jaeger ◽  
Whitley Hatton ◽  
Patrick Cotogno ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
San Francisco ◽  
Splice Variants ◽  
Circulating Tumor Dna ◽  
P Value ◽  
Fisher Exact Test ◽  
Chi Square ◽  
Exact Test ◽  
Viable Approach ◽  
Tumor Dna

200 Background: Circulating tumor-DNA (ctDNA) in mCRPC patients (pts) provides a viable approach for examining the genetic landscape of prostate cancer. In this follow-up, we report ctDNA variants in germline tested mCRPC pts. Methods: ctDNA alterations in 73 genes were detected using Guardant360 (G360) assays. Alteration types assessed were missense, frameshift, insertions, splice variants, truncations, amplifications (amp), deletions, and other. Pts included in the analysis received germline genetic testing (Invitae Corporation, San Francisco, CA) and ctDNA assays at various treatment timepoints. Statistical analyses were performed using chi-square and fisher exact test with p-value <0.05 for significance. Results: Germline and ctDNA testing was completed in 270 mCRPC pts. 13% (35/270) of pts had pathogenic germline alterations. Germline alterations detected were BRCA2 (43%, n=15), ATM (8.5%, n=3), CHEK2 (8.5%, n=3), and BRCA1 (6%, n=2). Of the 673 alterations detected in G360 assays, TP53 (25%, n=167) and AR (17%, n=117) were most commonly observed. ctDNA alteration breakdown for germline negative/positive pts is summarized in Tables A/B. Germline negative pts had more AR alterations compared to germline positive (p = 0.023). Also, germline negative pts presented with more amps (p < 0.001) and germline positive pts with more frameshift alterations (p = 0.005). The association of ctDNA alteration to clinical outcomes in germline positive/negative pts was also assessed and is ongoing. Conclusions: Pts with germline positive alterations had few somatic AR alterations and higher frequency of deleterious mutation in comparison to their germline negative counterparts.[Table: see text][Table: see text]

scholarly journals Absence of history of oral cleft in first-degree relatives of patients with prostate cancer

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Cláudia De Alvarenga Diniz Fonseca ◽  
Daniella Reis Barbosa Martelli ◽  
Ianná Luana Freitas Almeida ◽  
Galeno Hassen Sales ◽  
Rodrigo Soares de Andrade ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Cleft Lip ◽  
Control Group ◽  
Chi Square ◽  
Exact Test ◽  
First Degree Relatives ◽  
History Of ◽  
Risk Magnitude ◽  
Magnitude Assessment

Objective: To evaluate the occurrence of nonsyndromic cleft lip and/or palate (NSCL/P) in families of patients with prostate cancer (PC).Study design: We conducted a case-control study involving a total of 748 individuals, 280 of which had PC, and 468 were free-cancer healthy individuals. The patients answered a questionnaire with basic demographic information and family history of NSCL/P in first-degree relatives. The information collected was stored in a database and analyzed by using the statistical program SPSS® 24.0 for Windows (Chicago, IL, USA). In order to determine the association with NSCL/P, chi-square and Fisher’s exact test and odds ratio (OR) with its 95% confidence interval (95% CI) for risk magnitude assessment. Values with p<0.05 were considered statistically significant.Results: Of total patients with PC, 2 had a positive history of NSCL/P. In the control group, 7 patients reported family history of NSCL/P (1df chi-square, p=0.34; Fisher´s exact test, p=0.49). The average age of the cases diagnosed with PC was 71.35±7.70 years, and control group was 64.42±9.67 years.Conclusion: Despite the limited population, the frequency of NSCL/P was not significantly increased in the first-degree relatives of patients with PC. Studies with larger samples and molecular analyses are needed to better understand the possible relationships in the etiology of cancer and NSCL/P.

Inherited germline mutations in men with prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16564-e16564
Author(s):  
Robert Reid ◽  
Marcie DiGiovanni ◽  
Ryan Bernhisel ◽  
Krystal Brown ◽  
Jennifer Saam ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Genetic Testing ◽  
Family History ◽  
Hereditary Cancer ◽  
Clinical Information ◽  
Nccn Guidelines ◽  
Commercial Laboratory ◽  
Pathogenic Variants ◽  
Age Of Diagnosis ◽  
History Of

e16564 Background: Recent studies have demonstrated a high prevalence of pathogenic variants (PVs) in genes that confer hereditary cancer risk among men with metastatic prostate cancer (PC); however, PC does not currently receive attention as an indication for genetic testing. We assessed the clinical features of men with PC who received clinical testing as well as the distribution of PVs identified. Methods: A commercial laboratory database was queried to identify men with PC who underwent testing with a multi-gene hereditary cancer panel from September 2013–September 2016. Clinical information was obtained from provider-completed test request forms. Individuals with PC only were evaluated separately from those who had ≥1 additional malignancy. Personal/family history was evaluated relative to the 2013 NCCN guidelines for hereditary breast and ovarian cancer (HBOC) testing. Results: Overall, 700 men with a personal history of PC were identified: 384 (54.9%) with only PC and 316 (45.1%) with PC and ≥1 additional malignancy. The most common additional malignancies were colorectal (115) and breast cancer (105). The median age of diagnosis in men with only PC was 57.5, which is younger than tested men who had an additional malignancy (62) and the SEER data (2009-2013) for all men with PC (66). HBOC testing criteria were met by 75.9% of men, including 44 (6.3%) who met based only on a personal/family history of PC and 202 (28.9%) who met in part due to a personal/family history of PC. PVs were identified in 14.0% of all men: 11.5% of men with PC only and 17.1% of men with PC and a second malignancy (see Table). Conclusions: PC patients selected for genetic testing here were younger than men diagnosed with PC from the general population (SEER), and almost half had a diagnosis of an additional malignancy. They also have a high positive mutation rate across a broad spectrum of genes. [Table: see text]

Does a community cancer center one-day prostate cancer multidisciplinary clinic result in a change in treatment recommendation?

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 82-82
Author(s):  
Taylor Reid Cushman ◽  
Joseph W Mashni ◽  
Rachit Kumar
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Treatment Options ◽  
Retrospective Chart Review ◽  
Treatment Recommendations ◽  
Treatment Recommendation ◽  
Cancer Center ◽  
Risk Category ◽  
Stereotactic Radiation ◽  
Cancer Multiple

82 Background: Multi-disciplinary clinics (MDCs) offer patients the opportunity to meet with multiple providers to discuss treatment options for recently diagnosed prostate cancer. Multiple academic centers have published their experience with these clinics. However, this approach has been sparsely reported in the community setting. Herein, we assess if an MDC results in more appropriate treatment recommendations for patients based on NCCN risk category compared to incoming (non-MDC) treatment recommendations. Methods: A retrospective chart review of patients evaluated in the institutional prostate cancer MDC clinic were reviewed over a 22 month period (January 2015 through October 2016). A single urologist and radiation oncologist served as clinic consultants for all patients. Patients were asked to report the recommendation for treatment prior to evaluation in the MDC clinic, and the patient selection for treatment after evaluation in the MDC clinic. Changes in treatment recommendation were recorded based on NCCN risk category (low [LR], intermediate [IR], and high [HR] risk groups). Results: Eighty patients were evaluated in the MDC. Of the 80 patients, 64 (80%) chose to continue care with the providers in the prostate MDC. Evaluable records (i.e. initial treatment recommendations) were available for 46 of the 64 patients (72%). Median age of the evaluable patients was 67 years (range 43-83). By risk category, 15 (33%) were LR, 21 (46%) were IR, and 10 (22%) were HR. Eleven patients in the LR group (73%) had altered treatment recommendations, 82% of whom were changed from any treatment (surgery or radiation) to active surveillance. Ten patients in the IR group (48%) and four patients in the HR group (40%) had altered treatment recommendations, mostly from surgery to radiation +/- ADT (50% in the IR, and 75% in the HR group). For all patients seen in the MDC, eight (10%) enrolled on a clinical trial (prostate stereotactic radiation). Conclusions: Implementation of a community-based, one-day prostate MDC resulted in significant changes in treatment recommendations, particularly in increasing active surveillance for LR patients and reducing surgical intervention in IR and HR patients.

Sign in / Sign up

Export Citation Format

Share Document