BRCA: Mapping the mCRPC genetic landscape
Episode 3. Alicia Morgans and Gerhardt Attard discuss the clinical complexities of interpreting BRCA and non-BRCA HRR mutations in mCRPC. They explore how monoallelic versus biallelic loss, clonal hematopoiesis, and low tumor fractions in ctDNA testing can complicate decision-making. “The devil’s always in the detail,” Attard notes, as he shares why tumor fraction matters and why mislabeling patients as HRR-negative could mean missed treatment opportunities. The pair also unpack how testing limitations and mutation heterogeneity are influencing the timing and effectiveness of poly (ADP-ribose) polymerase (PARP) inhibitor use. View transcript.
Chapters
00:43 Understanding HRR complexity in mCRPC
05:42 HRR testing: What might we be missing?
11:23 Practical considerations for HRRm testing
13:37 HRRm testing and real-world outcomes
16:05 Multiple HRR mutations
18:00 Future directions in HRRm care
20:12 Wrap-up
Meet the guest speaker
Gerhardt Attard, MD, PhD, FRCP
Gerhardt Attard is the John Black Charitable Foundation Chair in Urological Cancer Research at University College London (UCL), UK. He leads the Treatment Resistance Group at the UCL Cancer Institute and is a Consultant Medical Oncologist at UCL Hospital. Gerhardt is also an experienced clinical trialist and co-author of over 250 peer-reviewed publications. His research focuses on treatment resistance and precision medicine in advanced prostate cancer.
Disclosures: Advisor and lecturer for AACR, Agilent, Cancer Research UK, and the Prostate Cancer Foundation.
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