Dr Garje on the Use of Genomic Testing and Targeted Therapy in Prostate Cancer

Rohan Garje, MD, chief, Genitourinary Medical Oncology, Miami Cancer Institute, Baptist Health, discusses the evolution of genomic testing and targeted treatment approaches in prostate cancer, as well as challenges associated with their implementation in clinical practice, as highlighted in his presentation at the Second Annual Miami Cancer Institute Precision Oncology Symposium.

Genomic testing has rapidly evolved in the field of prostate cancer over the past decade, driven primarily by the approvals of PARP inhibitors and other biomarker-driven therapies, Garje begins. Previously, genomic testing was not widely performed. However, the advent of targeted therapy in prostate cancer spurred a growing need for identifying biomarkers that can guide treatment selection and risk stratification for patients, Garje explains.

Although the feasibility and efficacy of biomarker-driven therapies is well established, their integration into real-world clinical practice has encountered challenges, resulting in a significant delay between regulatory approval and widespread adoption in community settings, Garje notes. Addressing this implementation gap is imperative to ensure patients benefit from timely access to precision medicine approaches, according to Garje. Efforts are underway to streamline the integration of genomic testing into routine clinical workflows, aiming to accelerate the translation of scientific advancements into improved patient care, Garje says.

One unique aspect of prostate cancer management is the use of novel prostate-specific membrane antigen (PSMA)–targeted imaging technologies, Garje continues. Advanced imaging agents enable the precise localization of cancerous lesions based on PSMA expression, providing valuable information for treatment planning, Garje explains. Leveraging these imaging data, agents such as lutetium Lu 177 vipivotide tetraxetan (Pluvicto) can selectively target PSMA-expressing prostate cancer cells, offering a personalized and effective treatment approach, Garje states.

The combination of genomic insights with image-driven identification of specific receptors represents a promising strategy to optimize treatment outcomes for patients with advanced prostate cancer, Garje emphasizes. By integrating cutting-edge technologies and therapies, clinicians can tailor treatment plans to individual patients, maximizing therapeutic efficacy and simultaneously minimizing toxicities, he explains.

Moving forward, efforts to enhance the adoption of genomic testing and innovative imaging techniques in prostate cancer care will continue to evolve, empowering clinicians to deliver targeted treatments that address patients' unique molecular characteristics, Garje concludes.