Repeat Next Generation Sequencing (NGS) testing upon progression in men with metastatic prostate cancer can identify new actionable alterations

Joseph J. Park; Alec Chu; Jinju Li; Alicia Ali; Rana R. McKay; Clara Hwang; Matthew K. Labriola; Albert Jang; Deepak Kilari; George Mo; Deepak Ravindranathan; Laura S. Graham; Alexandra Sokolova; Abhishek Tripathi; Amanda Pilling; Tanya Jindal; Aditya Ravindra; Patrick L. Sweeney; Frank C. Cackowski; Bicky Thapa; Taylor S. Amery; Elisabeth I. Heath; Rohan Garje; Yousef Zakharia; Vadim S. Koshkin; Mehmet A. Bilen; Michael T. Schweizer; Pedro C. Barata; Tanya B. Dorff; Marcin Cieslik; Ajjai S. Alva; Andrew J. Armstrong

doi:10.1200/PO.23.00567

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Repeat Next Generation Sequencing (NGS) testing upon progression in men with metastatic prostate cancer can identify new actionable alterations

Journal article

Peer reviewed

Repeat Next Generation Sequencing (NGS) testing upon progression in men with metastatic prostate cancer can identify new actionable alterations

Joseph J. Park, Alec Chu, Jinju Li, Alicia Ali, Rana R. McKay, Clara Hwang, Matthew K. Labriola, Albert Jang, Deepak Kilari, George Mo, …

JCO precision oncology, Vol.8, e2300567

04/01/2024

DOI: 10.1200/PO.23.00567

PMCID: PMC11018169

PMID: 38579192

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https://pmc.ncbi.nlm.nih.gov/articles/PMC11018169/pdf/po-8-e2300567.pdfView

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Abstract

Purpose: There are limited data available on the real-world patterns of molecular testing in men with advanced prostate cancer. We thus sought to evaluate next-generation sequencing (NGS) testing in the United States, focused on single versus serial NGS testing, the different disease states of testing (hormone-sensitive v castration-resistant, metastatic vs nonmetastatic), tissue versus plasma circulating tumor DNA (ctDNA) assays, and how often actionable data were found on each NGS test. Methods: The Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort clinical-genomic database was used for this retrospective analysis, including 1,597 patients across 15 institutions. Actionable NGS data were defined as including somatic alterations in homologous recombination repair genes, mismatch repair deficiency, microsatellite instability (MSI-high), or a high tumor mutational burden ≥10 mut/MB. Results: Serial NGS testing (two or more NGS tests with specimens collected more than 60 days apart) was performed in 9% (n = 144) of patients with a median of 182 days in between test results. For the second NGS test and beyond, 82.1% (225 of 274) of tests were from ctDNA assays and 76.1% (217 of 285) were collected in the metastatic castration-resistant setting. New actionable data were found on 11.1% (16 of 144) of second NGS tests, with 3.5% (5 of 144) of tests detecting a new BRCA2 alteration or MSI-high. A targeted therapy (poly (ADP-ribose) polymerase inhibitor or immunotherapy) was given after an actionable result on the second NGS test in 31.3% (5 of 16) of patients. Conclusion: Repeat somatic NGS testing in men with prostate cancer is infrequently performed in practice and can identify new actionable alterations not present with initial testing, suggesting the utility of repeat molecular profiling with tissue or blood of men with metastatic castration-resistant prostate cancer to guide therapy choices.

Details

Title: Subtitle: Repeat Next Generation Sequencing (NGS) testing upon progression in men with metastatic prostate cancer can identify new actionable alterations
Creators: Joseph J. Park - Duke University
Alec Chu - University of Michigan
Jinju Li - University of Michigan
Alicia Ali - University of Michigan
Rana R. McKay - University of California San Diego
Clara Hwang - Henry Ford Health System
Matthew K. Labriola - Duke University
Albert Jang - Tulane University
Deepak Kilari - Medical College of Wisconsin
George Mo - University of Washington
Deepak Ravindranathan - Emory University
Laura S. Graham - University of Colorado Anschutz Medical Campus
Alexandra Sokolova - Oregon Health & Science University
Abhishek Tripathi - City Of Hope National Medical Center
Amanda Pilling - Henry Ford Health System
Tanya Jindal - University of California, San Francisco
Aditya Ravindra - University of Iowa
Patrick L. Sweeney - Tulane University
Frank C. Cackowski - Wayne State University
Bicky Thapa - Medical College of Wisconsin
Taylor S. Amery - Oregon Health & Science University
Elisabeth I. Heath - Wayne State University
Rohan Garje
Yousef Zakharia - University of Iowa, Holden Comprehensive Cancer Center
Vadim S. Koshkin - University of California, San Francisco
Mehmet A. Bilen - Emory University
Michael T. Schweizer - University of Washington
Pedro C. Barata - Tulane University
Tanya B. Dorff - City Of Hope National Medical Center
Marcin Cieslik - University of Michigan
Ajjai S. Alva - University of Michigan
Andrew J. Armstrong - Duke University
Resource Type: Journal article
Publication Details: JCO precision oncology, Vol.8, e2300567
DOI: 10.1200/PO.23.00567
PMID: 38579192
PMCID: PMC11018169
NLM abbreviation: JCO Precis Oncol
ISSN: 2473-4284
eISSN: 2473-4284
Publisher: American Society of Clinical Oncology
Grant note: NCI/NIH: R01: 5R01CA233585-05
Supported by NCI/NIH R01: 5R01CA233585-05 (A.J.A.)
Language: English
Date published: 04/01/2024
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
Record Identifier: 9984803713602771

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