Prostate Cancer 101
What is the common blood test used to screen for prostate cancer?
PSA (Prostate Specific Antigen)
How many genes does the MyRisk Hereditary Cancer Test look at and how many corresponding different cancer sites?
48 and 11
What type of sample is Prolaris Biopsy Genomic Biomarker Ran on?
Prostate biopsy tissue that contains cancer.
What are the three types of cancer?
What does ADT stand for?
Androgen Deprivation Therapy
What procedure does a urologist perform to rule in or rule out prostate cancer when they have a patient referred to them with an elevated PSA?
In this procedure how many cores is usually taken?
A Prostate Biopsy - 12
What is the name of the clinical study that talks about the prevalence of genetic mutations in metastatic prostate cance?
Pritchard - New England Journal of Medicine
How many genes does the prolaris test look at and what types of genes are they?
31 CCP and 15 housekeeping genes
What are the three tests that make up the Urosuite?
Prolaris, MyRisk, and Precise
What is the preferred treatment option for a NCCN Low Risk Patient?
AS
DRE (Digital Rectal Exam)
Castro - 6x more likely to die
What are the name of the 2 key validation studies in conservatively managed men? What was one of the key take aways?
Cuzick 1 and 2
Prolaris was 2x more prognostic than PSA and Gleason.
Prolaris was able to better stratify an inidivuals mortality risk
Conservatively managed patients
What is the name of the part of the MyRisk result that helps a patient understand how to screen for additional risks?
MyRisk Management Tool
What was the Schreiber study and what was one key take away?
Primary and Secondary - Ex. 3+4=7 , Primary 3 secondary 4.
What are the two NCCN affected patient criteria for germline testing that do not require any additional family history?
Metastatic and NCCN Very High / High Risk
What is the AS threshold set at? What is the Multi-Modal Threshold set at?
What study validated the AS Threshold? What Studies validated the MM Thresholds?
3.2% and 8.9%
Lin AS Threshold Validation & Tward 1 & 2
What are the three red flags for hereditary cancer?
Young, Rare, Multiple
What was the Epstein Study looking at and what was one of the main takeaways?
10 top GU pathologists looking at standard slides, only agreed 66% of the time.
Bonus : Patient Case E!
What are the five critical clin/path features of the workup of prostate cancer?
Age, Percent cores positive, Pre-Biopsy PSA, Tumor Stage (DRE), Gleason Score
What are the 4 main clinical utility points for affected Prostate cancer patients and hereditary cancer testing?
PARPi, Secondary Cancer Risks, More aggressive Cancer, Impact on Family
What are the three main endpoints of the Prolaris result? What is the fourth feature of the test?
10-year DSM with Conservative management
10-year risk of Mets with Surgery or RT
10-year Risk of Mets with RT + ADT
ARR - benefit of adding ADT to RT
What year was Myriad Genetics founded?
1991
What NCCN Risk Categories does Medicare cover for Prolaris testing?
All Risk Categories