Skip to main content

Precision Medicine in Prostate Cancer: Approach to the Patient

  • Chapter
  • First Online:
Precision Molecular Pathology of Prostate Cancer

Abstract

The advent of genomic discoveries and decreasing cost of next-generation sequencing (NGS) technologies has ushered in a new era of precision medicine. The early effects of this paradigm shift in oncology are beginning to impact patient care and thus increase the relevance of a discussion on the approach to patients with prostate cancer (PC). Bringing the application of precision medicine to the clinic raises new challenges related to informed consent prior to testing, effectively communicating the results of cancer genomic testing to the patient, understanding and managing the patient’s expectations, and working with the patient to select the best treatment options based on genomic tests (or not). This introductory chapter will cover the approach to men with PC undergoing genomic testing of their tumors.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Collins FS, Varmus H. A new initiative on precision medicine. N Engl J Med. 2015;372(9):793–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Hollebecque A, Massard C, Soria J-C. Implementing precision medicine initiatives in the clinic: a new paradigm in drug development. Curr Opin Oncol. 2014;26(3):340–6.

    Article  CAS  PubMed  Google Scholar 

  3. Miller FA, Hayeems RZ, Bytautas JP, Bedard PL, Ernst S, Hirte H, et al. Testing personalized medicine: patient and physician expectations of next-generation genomic sequencing in late-stage cancer care. Eur J Hum Genet. 2013;22(3):391–5.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5–29.

    Article  PubMed  Google Scholar 

  5. Beltran H, Rubin MA. New strategies in prostate cancer: translating genomics into the clinic. Clin Cancer Res. 2013;19(3):517–23.

    Article  CAS  PubMed  Google Scholar 

  6. De la Calle C, Patil D, Wei JT, Scherr DS, Sokoll L, Chan DW, et al. Multicenter evaluation of the prostate health index to detect aggressive prostate cancer in biopsy naĂ¯ve men. J Urol. 2015;5347(15):183–4.

    Google Scholar 

  7. Cooperberg MR, Davicioni E, Crisan A, Jenkins RB, Ghadessi M, Karnes RJ. Combined value of validated clinical and genomic risk stratification tools for predicting prostate cancer mortality in a high-risk prostatectomy cohort. Eur Urol. 2015;67(2):326–33.

    Article  PubMed  Google Scholar 

  8. Genomic Health Announces Favorable Draft Local Coverage Determination from Palmetto GBA® on Medicare Coverage for the Oncotype DX® Prostate Cancer Test [Internet]. [cited 2015 May 27]. Available from: http://www.prnewswire.com/news-releases/genomic-health-announces-favorable-draft-local-coverage-determination-from-palmetto-gba-on-medicare-coverage-for-the-oncotype-dx-prostate-cancer-test-300087008.html.

  9. Tomlins SA, Aubin SMJ, Siddiqui J, Lonigro RJ, Sefton-Miller L, Miick S, et al. Urine TMPRSS2:ERG fusion transcript stratifies prostate cancer risk in men with elevated serum PSA. Sci Transl Med. 2011;3(94):94ra72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Prensner JR, Zhao S, Erho N, Schipper M, Iyer MK, Dhanasekaran SM, et al. RNA biomarkers associated with metastatic progression in prostate cancer: a multi-institutional high-throughput analysis of SChLAP1. Lancet Oncol. 2014;15(13):1469–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Robinson D, Van Allen EM, Wu Y-M, Schultz N, Lonigro RJ, Mosquera J-M, et al. Integrative clinical genomics of advanced prostate cancer. Cell. 2015;161(5):1215–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Beltran H, Eng K, Mosquera JM, Sigaras A, Romanel A, Rennert H, et al. Whole-exome sequencing of metastatic cancer and biomarkers of treatment response. JAMA Oncol. 2015 1(4):466-474

    Google Scholar 

  13. Roychowdhury S, Chinnaiyan AM. Advancing precision medicine for prostate cancer through genomics. J Clin Oncol. 2013;31(15):1866–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Rubin MA. Health: make precision medicine work for cancer care. Nature. 2015;520(7547):290–1.

    Article  CAS  PubMed  Google Scholar 

  15. Demichelis F, Stanford JL. Genetic predisposition to prostate cancer: update and future perspectives. Urol Oncol. 2015;33(2):75–84.

    Article  PubMed  Google Scholar 

  16. Pritchard CC, Mateo J, Walsh MF, De Sarkar N, Abida W, Beltran H, Garofalo A, Gulati R, Carreira S, Eeles R, Elemento O, Rubin MA, Robinson D, Lonigro R, Hussain M, Chinnaiyan A, Vinson J, Filipenko J, Garraway L, Taplin ME, AlDubayan S, Han GC, Beightol M, Morrissey C, Nghiem B, Cheng HH, Montgomery B, Walsh T, Casadei S, Berger M, Zhang L, Zehir A, Vijai J, Scher HI, Sawyers C, Schultz N, Kantoff PW, Solit D, Robson M, Van Allen EM, Offit K, de Bono J, Nelson PS. Inherited DNA-Repair Gene Mutations in Men with Metastatic Prostate Cancer. N Engl J Med. 2016 Aug 4;375(5):443-53.

    Google Scholar 

  17. Cornetta K, Brown CG. Balancing personalized medicine and personalized care. Acad Med. 2013;88(3):309–13.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kaiser J. Obama gives East Room rollout to Precision Medicine Initiative [Internet]. Science. 2015 [cited 2015 Jun 29]. Available from: http://news.sciencemag.org/biology/2015/01/obama-gives-east-room-rollout-precision-medicine-initiative.

  19. Reardon S. Precision-medicine plan raises hopes. Nature. 2015;517:540.

    Article  CAS  PubMed  Google Scholar 

  20. Simon R, Roychowdhury S. Implementing personalized cancer genomics in clinical trials. Nat Rev Drug Discov. 2013;12(5):358–69.

    Article  CAS  PubMed  Google Scholar 

  21. Bartnik N, Roberts J, Gornick M, Le L, Chinnaiyan A. Are oncologists using genome sequencing results to inform patient care? 2015 ASCO Annual Meeting Abstracts [Internet]. J Clin Oncol. 2015 [cited 2015 May 13]. p. suppl; abstr e12525. Available from: http://abstracts.asco.org/156/AbstView_156_151842.html.

  22. Cohen RL, Settleman J. From cancer genomics to precision oncology—tissue’s still an issue. Cell. 2014;157(7):1509–14.

    Article  CAS  PubMed  Google Scholar 

  23. Van Allen EM, Foye A, Wagle N, Kim W, Carter SL, McKenna A, et al. Successful whole-exome sequencing from a prostate cancer bone metastasis biopsy. Prostate Cancer Prostatic Dis. 2014;17(1):23–7.

    Article  PubMed  Google Scholar 

  24. Toss A, Mu Z, Fernandez S, Cristofanilli M. CTC enumeration and characterization: moving toward personalized medicine. Ann Transl Med. 2014;2(11):108.

    PubMed  PubMed Central  Google Scholar 

  25. Gold B, Cankovic M, Furtado LV, Meier F, Gocke CD. Do circulating tumor cells, exosomes, and circulating tumor nucleic acids have clinical utility?: a report of the association for molecular pathology. J Mol Diagn. 2015;17(3):209–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Yap TA, Lorente D, Omlin A, Olmos D, de Bono JS. Circulating tumor cells: a multifunctional biomarker. Clin Cancer Res. 2014;20(10):2553–68.

    Article  CAS  PubMed  Google Scholar 

  27. Gao D, Vela I, Sboner A, Iaquinta PJ, Karthaus WR, Gopalan A, et al. Organoid cultures derived from patients with advanced prostate cancer. Cell. 2014;159(1):176–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Katsanis SH, Minear MA, Vorderstrasse A, Yang N, Reeves JW, Rakhra-Burris T, et al. Perspectives on genetic and genomic technologies in an academic medical center: the duke experience. J Pers Med. 2015;5(2):67–82.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Rodon J, Soria JC, Berger R, Batist G, Tsimberidou A, Bresson C, et al. Challenges in initiating and conducting personalized cancer therapy trials: perspectives from WINTHER, a Worldwide Innovative Network (WIN) Consortium Trial. Ann Oncol. 2015;26(8):1791–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Forrest K, Simpson SA, Wilson BJ, van Teijlingen ER, McKee L, Haites N, et al. To tell or not to tell: barriers and facilitators in family communication about genetic risk. Clin Genet. 2003;64(4):317–26.

    Article  CAS  PubMed  Google Scholar 

  31. Stadler ZK, Schrader KA, Vijai J, Robson ME, Offit K. Cancer genomics and inherited risk. J Clin Oncol. 2014;32(7):687–98.

    Article  CAS  PubMed  Google Scholar 

  32. Communicating Genetic Test Results to Patients and Their Families [Internet]. [cited 2015 Jun 2]. Available from: https://am.asco.org/communicating-genetic-test-results-patients-and-their-families.

  33. Everett JN, Gustafson SL, Raymond VM. Traditional roles in a non-traditional setting: genetic counseling in precision oncology. J Genet Couns. 2014;23(4):655–60.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Yushak M, Bouberhan S, Han G, Epstein L, Mougalian S, Abu-Khalaf M, et al. Patient preferences for disclosure of incidental genetic information discovered through high-throughput sequencing [Internet]. 2015 [cited 2015 Apr 28]. Available from: http://www.abstractsonline.com/Plan/ViewAbstract.aspx?mID=3682&sKey=ec0677d3-a055–44be-bfb3–7420b2d03869&cKey=9ca3a8ba-f3e7–428b-a162–67ffd36a260a&mKey=19573a54-ae8f-4e00–9c23-bd6d62268424.

  35. Shrager J, Tenenbaum JM. Rapid learning for precision oncology. Nat Rev Clin Oncol. 2014;11(2):109–18.

    Article  PubMed  Google Scholar 

  36. Rubin MA. Toward a prostate cancer precision medicine. Urol Oncol. 2015;33(2):73–4.

    Article  PubMed  Google Scholar 

  37. Antonarakis ES, Lu C, Wang H, Luber B, Nakazawa M, Roeser JC, et al. AR-V7 and resistance to enzalutamide and abiraterone in prostate cancer. N Engl J Med. 2014;371(11):1028–38.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Scott T. Tagawa M.D., M.S. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Karir, B.S., Faltas, B.M., Tagawa, S.T. (2018). Precision Medicine in Prostate Cancer: Approach to the Patient. In: Robinson, B., Mosquera, J., Ro, J., Divatia, M. (eds) Precision Molecular Pathology of Prostate Cancer. Molecular Pathology Library. Springer, Cham. https://doi.org/10.1007/978-3-319-64096-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-64096-9_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-64094-5

  • Online ISBN: 978-3-319-64096-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics