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Related Concept Videos

Tumor Progression02:07

Tumor Progression

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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
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Repeat Next-Generation Sequencing Testing on Progression in Men With Metastatic Prostate Cancer Can Identify New

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This summary is machine-generated.

Serial next-generation sequencing (NGS) testing in advanced prostate cancer is uncommon but can reveal new actionable alterations. Repeat molecular profiling, especially in metastatic castration-resistant disease, helps guide therapy choices.

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Area of Science:

  • Oncology
  • Genetics
  • Precision Medicine

Background:

  • Limited real-world data exists on molecular testing patterns in advanced prostate cancer.
  • Understanding patterns of next-generation sequencing (NGS) is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To evaluate real-world NGS testing patterns in the US for advanced prostate cancer.
  • To analyze single vs. serial NGS testing, disease states, and assay types (tissue vs. plasma circulating tumor DNA [ctDNA]).
  • To determine the frequency of actionable data identification with NGS.

Main Methods:

  • Retrospective analysis of 1,597 patients from the Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort database.
  • Defined actionable NGS data as somatic alterations in homologous recombination repair genes, mismatch repair deficiency, MSI-high, or high tumor mutational burden (≥10 mut/MB).
  • Focused on single vs. serial NGS testing, disease states (hormone-sensitive vs. castration-resistant, metastatic vs. nonmetastatic), and tissue vs. plasma ctDNA assays.

Main Results:

  • Serial NGS testing was performed in 9% of patients, with a median of 182 days between tests.
  • Second NGS tests were predominantly ctDNA assays (82.1%) in the metastatic castration-resistant setting (76.1%).
  • New actionable data were identified in 11.1% of second NGS tests, including 3.5% with BRCA2 alterations or MSI-high, leading to targeted therapy in 31.3% of cases.

Conclusions:

  • Repeat somatic NGS testing is infrequently utilized in clinical practice for prostate cancer.
  • Serial NGS testing can uncover new actionable alterations missed by initial testing.
  • Repeat molecular profiling in metastatic castration-resistant prostate cancer (mCRPC) is valuable for guiding therapy.