Guidelines Insufficient for Prostate Cancer Germline Genetic Testing
According to researchers, only 43.8% of positive genetic variants detected in men with prostate cancer had corresponding recommendations for germline testing in National Comprehensive Cancer Network (NCCN) guidelines. The findings were published in JAMA Oncology (https://doi.org/10.1001/jamaoncol.2018.6760).
Current NCCN guidelines call for germline testing of BRCA1 and 2, ATM, PALB2, and FANCA genes in men with metastatic, regional, or high-risk disease regardless of family history as well as men with lower-risk disease and a strong family history. The guidelines also recommend BRCA1 and 2 testing for a Gleason score of 7 or higher in men with a personal history.
Researchers evaluated data from 3,607 men with a personal history of prostate cancer and who had received germline testing between 2013 and 2018. Overall, 17.2% of participants had a positive germline variant, but more than half were in genes not included in current NCCN guideline recommendations.
The study authors suggested expanding the guidelines to include testing for all men with prostate cancer to make them more in line with guidelines for pancreatic and colorectal cancer.