BRCA1/2 in Metastatic Prostate Cancer

EP: 1.Diagnosing Metastatic Prostate Cancer

EP: 2.Biomarker Testing in Metastatic Prostate Cancer

EP: 3.Treatment Options for Metastatic Prostate Cancer

EP: 4.The Role of PARP Inhibitors in Prostate Cancer

EP: 5.Rucaparib for Prostate Cancer

EP: 6.Advances in Metastatic Castration-Resistant Prostate Cancer

EP: 7.Routinely Ordered Testing for Metastatic Prostate Cancer

EP: 8.Biomarker Testing Protocols for Metastatic Prostate Cancer and What to Look For

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EP: 9.BRCA1/2 in Metastatic Prostate Cancer

EP: 10.Systemic Treatment Options for Metastatic Castration-Resistant Prostate Cancer

EP: 11.Selecting Appropriate Treatment and Monitoring Patients on Metastatic Prostate Cancer Therapy

EP: 12.The Role of PARP Inhibitors and Adverse Events in Metastatic Prostate Cancer Therapy

EP: 13.Other Factors Considered When Adding PARP Inhibitors to Metastatic Prostate Cancer Therapy

EP: 14.Patient Access and Metastatic Prostate Cancer Therapy

EP: 15.Sequencing Strategies for Metastatic Castration-Resistant Prostate Cancer Therapy

EP: 16.Exciting Advances in the Therapeutic Space and Clinical Pearls for Treating Metastatic Prostate Cancer

EP: 17.Recap: Recommendations for PARP Inhibitor Use in Prostate Cancer

EP: 18.Recap: Testing and Treating Metastatic Castration-Resistant Prostate Cancer

Matthew Fowler: What is the role of BRCA1/2 in prostate cancer? What percentage of men with prostate cancer harbor a BRCA1 or BRCA2 mutation?

Alicia Morgans, MD, MPH: BRCA2 is the most common. BRCA1 is much less common. When we think about all the DNA-repair defect alterations that we can target with PARP inhibitors, it’s about 11.8% of men with metastatic cancer. About 10% of these might be BRCA2, and a much smaller percentage might be BRCA1. But BRCA2 is the most common in men with prostate cancer. We’ll often see that these men have an aunt with breast cancer or their mother had ovarian cancer, in addition to male family members who have a history of prostate cancer. As we think about these heritable mutations, it’s important to recognize that they can be associated with not just prostate cancer but cancer syndromes outside prostate cancer, including breast and ovarian cancer.

The other important thing to remember is that the guidelines suggest for germline testing in particular that we don’t do only germline testing in men who are younger at the time of diagnosis or who have family members who have a history of these cancers that may be involved in these syndromes. Because what was so fascinating is that the 11.8% of men with metastatic prostate cancer who have these germline heritable mutations didn’t have a higher rate if they had a family member who had a history of one of these cancers. It can be a clue that we may be ready to see one of these alterations in the germline of one of our patients, but it’s not a clear and definite association that would necessarily guide our germline testing.

This transcript has been edited for clarity.