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Cancer Survival Analysis01:21

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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...

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Abiraterone, Olaparib, or Abiraterone + Olaparib in First-Line Metastatic Castration-Resistant Prostate Cancer with DNA Repair Defects (BRCAAway).

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A Real-World Prospective Study of Comprehensive Genomic Testing in Patients With Metastatic Castration-Resistant

Daniel Shevrin1, Mathew Yang2, Linda M Sabatini3

  • 1Division of Hematology and Oncology, Department of Medicine, Endeavor Health, Evanston, IL.

Clinical Genitourinary Cancer
|May 20, 2026
PubMed
Summary

Comprehensive genomic testing, including circulating tumor DNA (ctDNA), identified actionable alterations in 45% of metastatic castration-resistant prostate cancer patients. Tissue testing challenges were noted, but repeat ctDNA detected additional alterations.

Keywords:
Germline testingLiquid biopsyPARP inhibitorsRepeat genomic testingctDNA

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Area of Science:

  • Oncology
  • Genomics
  • Molecular Diagnostics

Background:

  • Somatic genomic testing is standard for metastatic castration-resistant prostate cancer (mCRPC).
  • Guidelines recommend tissue testing, but consensus on tissue type and integrating circulating tumor DNA (ctDNA) is lacking.
  • This study evaluated simultaneous germline, tissue, and ctDNA testing in a community setting.

Purpose of the Study:

  • To assess the feasibility of comprehensive genomic testing in mCRPC patients.
  • To determine the detection rate of actionable alterations using germline, tissue, and ctDNA.
  • To evaluate the utility of repeat ctDNA testing at progression.

Main Methods:

  • 150 mCRPC patients underwent simultaneous germline and initial ctDNA testing.
  • Tissue testing was performed when available.
  • Repeat ctDNA testing was conducted in selected patients upon tumor progression.

Main Results:

  • 67% (45%) of patients had an actionable alteration.
  • Initial ctDNA identified 27%, tissue 8%, and repeat ctDNA 10% of actionable alterations.
  • Tissue results were available for only 72 of 150 patients, highlighting tissue acquisition challenges.

Conclusions:

  • Comprehensive genomic testing in a community setting successfully identified actionable alterations in a significant proportion of mCRPC patients.
  • Challenges in obtaining adequate tumor tissue underscore the importance of alternative methods like ctDNA.
  • Repeat ctDNA testing at progression proved valuable for detecting additional actionable alterations.