Alan H. Bryce, MD, presented “Genetic Testing & Next Generation DNA Sequencing” during the 29th Annual Perspectives in Urology: Point-Counterpoint, on November 20, 2021, in Coronado Island, San Diego, California.
How to cite: Bryce, Alan H. “Genetic Testing & Next Generation DNA Sequencing.” November 20, 2021. Accessed Jul 2024. https://grandroundsinurology.com/genetic-testing-next-generation-dna-sequencing/
Genetic Testing & Next Generation DNA Sequencing
Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, discusses genetic testing, next generation DNA sequencing, and the genetic diversity of prostate cancer (PCa) in regard to treatment. He begins by reviewing the germline BRCA mutations, stating that BRCA1 and BRCA2 mutations individually make up fewer than 1.3% of all cases of localized PCa. Dr. Bryce then discusses BRCA2 in detail, focusing on how BRCA2 carriers are considered high risk by the NCCN guidelines, which recommend PSA screening discussions to start at age 45. He evaluates traditional guidelines in the context of germline mutations, finding that genetic testing and Gleason score guidelines do not reliably identify PCa patients for the presence/absence of high-risk germline mutations. Dr. Bryce then discusses the mutational landscape by disease state, displaying how PCa evolves as it advances to become metastatic and castration resistant and supporting the idea that a genomic understanding of an individual’s disease is key to treatment. He reviews the approval of olaparib, a PARP inhibitor, and the PROfound trial. Dr. Bryce concludes that inherited prostate cancer risk syndromes are under-recognized, both in practice and in research, that PCa is genetically diverse, that the impact of treatments on tumor evolution should be evaluated, and that multiple new pathways for therapeutic targeting have been identified.
About the 29th Annual Perspectives in Urology: Point Counterpoint conference:
Presented by Program Chair and Grand Rounds in Urology Editor-in-Chief E. David Crawford, MD, this conference brought together leading experts in urology, medical oncology, and radiation oncology to discuss and debate the latest topics in genitourinary cancers, primarily prostate cancer and bladder cancer. This interactive conference offered topical lectures, pro/con debates, interesting-case presentations, interactive panel discussions, and interactive audience and faculty networking.
ABOUT THE AUTHOR
Alan H. Bryce, MD, is a medical oncologist and chief clinical officer at City of Hope in Phoenix, Arizona. Dr. Bryce holds an appointment as a professor with the Department of Medical Oncology & Therapeutics Research, with City of Hope, as well as an appointment as a professor of Molecular Medicine at Translational Genomics Research Institute (TGen), which is also part of City of Hope.
Prior to joining City of Hope, Dr. Bryce spent 12 years at the Mayo Clinic in Phoenix, where he served as chair of the Division of Hematology and Medical Oncology, as well as Director of the Mayo Clinic Arizona Comprehensive Cancer Center. Dr. Bryce received his medical degree from the Chicago Medical School, and then completed an internal medicine residency and a hematology and oncology fellowship at the Mayo Clinic in Rochester, Minnesota. During his time at Mayo, Dr. Bryce served as an international co-principal investigator on multiple clinical trials for prostate cancer, with his research focused on cancer genetics, novel therapies and immunotherapeutic approaches.
