Enhancing genetic testing practice in mPC
As HRR testing becomes a cornerstone of personalized care in metastatic prostate cancer (mPC), how do we ensure it’s implemented equitably and effectively across all clinical settings? Arun Azad unpacks the real-world barriers to implementing HRR testing in mPC, from clinician education and workflow integration to funding, access, and persistent misconceptions. He highlights the importance of multidisciplinary collaboration, reflex testing, and targeted advocacy to ensure equitable access across diverse clinical settings. “We’re denying some patients the opportunity to have another therapy that could extend their life and improve their quality of life if we don’t do the testing,” Azad warns, underscoring the urgency of closing the gap. View transcript.
Chapters
00:00 Barriers to integrating HRR testing
00:42 Are we prepared to support HRR testing?
02:57 Regional impact of HRR testing funding
03:58 Clinician training in HRR testing
05:16 HRR testing misconceptions by specialty
06:41 How does education guide decisions?
07:51 Do demographics affect HRR testing?
09:28 How to support equitable HRR testing
10:42 Can policies support HRR testing?
11:58 Can innovation expand HRR testing?
13:21 Can advocacy reduce HRR testing gaps?
14:01 Checklist: How to implement HRR testing
As genetic testing becomes more embedded in mPC care, how do we ensure the samples we collect truly support accurate, actionable results? Anders Bjartell discusses how timing, tumor content, and coordinated workflows can determine the success or failure of real-world genetic testing in mPC, including why multidisciplinary coordination is critical as HRR testing becomes routine and how delays in processing or low tumor content can undermine ctDNA analysis. Bjartell concludes by looking ahead to where innovation and smarter quality assurance could help close today’s gaps. View transcript.
Chapters
00:03 Collecting high-quality tissue samples
01:00 Lessons learned from RWD
02:58 NGS and HRR testing: Sample integrity
05:49 Tissue vs liquid biopsy: ctDNA testing
08:19 Real-world benefits of liquid biopsy
09:20 Real‑world drivers of sample quality
11:40 Multidisciplinary sample collection
12:48 Training clinicians in sample collection
15:59 Looking ahead: Future approaches
18:44 Integrating AI/ML into sample analysis
Read ASCO 2025 highlights on HRR in treatment selection, including insights on racial disparities in HRR-driven mPC.
Ready to find out more about how HRR testing is reshaping clinical decision-making in mPC? Join Alicia Morgans and global experts as they break down the evolving science, testing innovations, and the real‑world impact of HRR‑driven precision medicine in this podcast series: Expert exchanges – HRR in mPC.
Meet the experts
Arun Azad, MBBS, FRACP, PhD
Arun Azad is a Professor of Medical Oncology at the University of Melbourne and a Consultant Medical Oncologist at the Peter MacCallum Cancer Centre in Melbourne, Australia. Azad has served in leadership roles across multiple international clinical trial steering committees. He is the Translational Chair of the Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group and Urologic Oncology Chair at the Clinical Oncology Society of Australia. He also contributes to international standards of care as a member of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines Committee for prostate cancer.
Disclosures: Honoraria from Aculeus Therapeutics, Amgen, Arvinas, Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Daiichi Sankyo, Ipsen, Janssen, Merck Serono, Merck Sharpe Dohme, Novartis, Noxopharm, Pfizer, Sanofi, Telix, and Tolmar. Member of scientific advisory board for Amgen, Arvinas, Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Daiichi Sankyo, Ipsen, Janssen, Merck Serono, Merck Sharpe Dohme, Novartis, Noxopharm, Pfizer, Sanofi, Telix, and Tolmar. Travel and accommodation support from Amgen, Astellas, Bayer, Hinova, Janssen, Merck Serono, Novartis, Pfizer, and Tolmar. Research funding from Aptevo Therapeutics (institutional), Astellas (investigator), Astellas (institutional), AstraZeneca (institutional), AstraZeneca (investigator), Bayer (institutional), Bionomics (institutional), Bristol Myers Squibb (institutional), Eli Lilly (institutional), Exelixis (institutional), Gilead Sciences (institutional), GlaxoSmithKline (institutional), Hinova (institutional), Ipsen (institutional), Janssen (institutional), MedImmune (institutional), Merck Serono (investigator), Merck Serono (institutional), Merck Sharpe Dohme (institutional), Novartis (institutional), Pfizer (institutional), Sanofi (institutional), and SYNthorx (institutional). Member of steering committee for AstraZeneca, Arvinas, Astellas, Exelixis, Janssen, Pfizer, and Merck Sharpe Dohme.
Anders Bjartell, MD, PhD, FEBU
Anders Bjartell is Professor of Clinical Urology at Lund University and a Senior Consultant Urologist at Skåne University Hospital in Malmö, Sweden. He has served as Associate Editor of European Urology; President and board member of the EAU Section of Urological Research (ESUR); Chairman of the EAU Research Foundation for 8 years; and a board member of the EAU Guidelines Office since 2016. Bjartell leads a translational prostate cancer research group with extensive experience in biomarker development and has served as national principal investigator for multiple mPC trials.
Disclosures: Consulting, advisory roles, or speaker honoraria from Accord, Astellas, AstraZeneca, Bayer, Ipsen, Johnson & Johnson, Lantheus, Novartis, Pfizer, and Sandoz. Research funding from Astellas, AstraZeneca, Bayer, Curasight, Johnson & Johnson, Novartis, Pfizer, Spectracure, and Telix. Co‑founder, board member, and shareholder of Glactone Pharma.
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