Prostate Cancer Management Decisions from Germline and Somatic Testing

Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, FACS, presented “Prostate Cancer Management Decisions From Germline and Somatic Testing” during the 35th International Prostate Cancer Update conference on February 11, 2025, in Vail, Colorado.

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How to cite: Gomella, LG. Prostate Cancer Management Decisions From Germline and Somatic Testing. February 11, 2025. Accessed Nov 2025. https://grandroundsinurology.com/prostate-cancer-management-decisions-from-germline-and-somatic-testing/

Prostate Cancer Management Decisions From Germline and Somatic Testing – Summary

Leonard G. Gomella, MD, FACS, Bernard W. Godwin, Jr. Professor of Prostate Cancer and Chairman of the Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, explores the role of germline and somatic testing in guiding prostate cancer management decisions. In this 16-minute presentation, Dr. Gomella shares that germline mutations elevate the risk of developing prostate cancer, influencing prognosis.

Somatic mutations, arising within tumors, are increasingly used to guide therapeutic decisions.

Dr. Gomella highlights the importance of somatic testing in identifying actionable mutations for targeted therapies such as PARP inhibitors and pembrolizumab. He emphasizes the HRR pathway’s role in DNA repair. Genetic testing is essential for patients with newly diagnosed metastatic castration-resistant prostate cancer, as recommended by multiple clinical guidelines.

Dr. Gomella underscores the need for precision medicine strategies incorporating genomic insights to personalize treatment. He also highlights the utility of liquid biopsies in identifying mutations noninvasively, minimizing the need for repeat tissue biopsies. He advocates for involving genetic counselors to manage complex results.

ABOUT THE AUTHOR

Leonard G. Gomella, MD, FACS

Bernard W. Godwin, Jr. Professor in Prostate Cancer at Thomas Jefferson University | + posts

Leonard G. Gomella, MD, FACS, completed medical school and general surgery and urology training at the University of Kentucky in Lexington. After a urologic oncology fellowship in the surgery branch of the National Cancer Institute, National Institutes of Health in Bethesda, Maryland. Dr. Gomella is currently the Bernard W. Godwin, Jr. Professor of Prostate Cancer, Chairman of the Department of Urology, Senior Director of Clinical Affairs for the Sidney Kimmel Comprehensive Cancer Center, and the Enterprise VP of Urology at the Jefferson Health System, at Thomas Jefferson University in Philadelphia, Pennsylvania.

About The Author

Leonard G. Gomella, MD, FACS

Leonard G. Gomella, MD, FACS, completed medical school and general surgery and urology training at the University of Kentucky in Lexington. After a urologic oncology fellowship in the surgery branch of the National Cancer Institute, National Institutes of Health in Bethesda, Maryland. Dr. Gomella is currently the Bernard W. Godwin, Jr. Professor of Prostate Cancer, Chairman of the Department of Urology, Senior Director of Clinical Affairs for the Sidney Kimmel Comprehensive Cancer Center, and the Enterprise VP of Urology at the Jefferson Health System, at Thomas Jefferson University in Philadelphia, Pennsylvania. Dr. Gomella is involved in both basic science and clinical research in the development of new diagnostic techniques and treatments for prostate, bladder and kidney cancer through Jefferson’s Sidney Kimmel Comprehensive Cancer Center. Dr. Gomella's team was first to use RT-PCR to detect micrometastasis in patients with prostate cancer, a discovery that led to a new field of investigation in this disease. Dr. Gomella is also recognized as an early contributor to urologic laparoscopy, initiating the program at Jefferson in 1990. Dr. Gomella has given almost 500 presentations at local, national and international meetings and written over 300 papers, chapters and monographs in the field of Urology. Dr. Gomella has authored and edited 54 editions of 17 different books for medical students, residents, and practicing physicians, many of which have been translated into foreign languages. He is the editor-in-chief of the 5 Minute Urology Consult, and laparoscopy section editor for Glenn’s Urologic Surgery. Recovering from Prostate Cancer, the first book for the public dedicated to this topic, was authored by Dr. Gomella. In the field of medicine, Dr. Gomella is known for the Clinician's Pocket Reference, now in its 11th edition, a widely used reference for medical students and health care providers.

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