Alan H. Bryce, MD

Alan H. Bryce, MD

Mayo Clinic

Scottsdale, Arizona

Dr. Bryce is the Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, where he utilizes whole genome sequencing of tumors to identify key driver mutations. This approach allows for precise targeting of a patient’s tumor, leading to a greater chance of remission. Dr. Bryce received a BS in Biochemistry from the University of California, Los Angeles. He then went on to receive his MD from Finch University of Health Sciences/Chicago Medical School. He completed a residency at the Mayo Graduate School of Medicine, and then received a Fellowship in Hematology/Oncology, also at the Mayo Graduate School of Medicine. He eventually served as Chief Fellow of Hematology/Medical Oncology there. Dr. Bryce studies cancer genetics and novel therapeutics with a focus on personalized medicine. His clinical practice centers on genitourinary malignancies (prostate, kidney, bladder, and testicular cancers) and melanoma. In addition, Dr. Bryce participates in community outreach to underserved populations and has an interest in health disparities research. He also conducts Phase I clinical trials of new cancer drugs.

Disclosures:

Articles by Alan H. Bryce, MD

Universal Germline Screening in Prostate Cancer: The Argument Against

Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic in Scottsdale, Arizona, argues against universal germline screening in prostate cancer in a point-counterpoint debate. While he agrees that identifying germline mutations is important and can have important implications for therapy and for patients’ families, Dr. Bryce observes that very few carriers are identified through germline testing. Approximately ⅔ of carriers are identified through family history-based screening, and while germline mutations are more common in men with metastatic cancer, they are uncommon in the total prostate cancer population. This means that among low- and intermediate-risk patients, 200-300 people must be screened to find one additional carrier, and among high-risk patients, approximately 50 people must be screened to find an additional carrier. Genetic testing costs money and takes up valuable counseling time, so Dr. Bryce argues that testing all patients is not a sensible allocation of resources.

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Updates in PARP Inhibition and Germline Testing in Prostate Cancer

Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, outlines recent treatment updates for prostate cancer patients, beginning with a brief review of germline testing recommendations. Following this, Dr. Bryce discusses two newly-approved PARP inhibitors that target mutations: rucaparib and olaparib. Dr. Bryce then poses a series of questions and challenges that physicians should consider as ongoing trials for various disease states and combinations (neoadjuvant, metastatic castrate sensitive prostate cancer, firstline metastatic castrate resistance prostate cancner, PARP inhibition + immunotherapy, etc.) continue.

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Genetics and Biomarkers for Prostate Cancer and Bladder Cancer

Alan H. Bryce, MD, Medical Director of the Genomic Oncology Clinic at Mayo Clinic Arizona in Scottsdale, discusses genetics and biomarkers for prostate cancer and bladder cancer. Genetic testing is now considered part of best practice for the treatment of cancer, but even still the topic can be confusing due to the number of different test types and scenarios. In order to combat this confusion, it is important that urologists continue to educate themselves on the matter. Dr. Bryce discusses the purpose of using either germline or somatic tests and the different information they can tell us. He goes into particular detail about the somatic test and how useful it can be in determining which targeted therapies to use for both prostate and bladder cancer. Finally, he also offers some advice on best practices for utilizing the somatic test including: testing every patient, always using a fresh biopsy, and retesting before each line of systemic therapy.

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Genetic Testing and Next Generation DNA Sequencing in Prostate Cancer

Alan H. Bryce, MD, Associate Professor of Medicine at the Mayo Clinic in Phoenix, Arizona, gives an update on how and why to use germline and somatic testing in prostate cancer. He discusses updated National Comprehensive Cancer Network and Society of Urologic Oncology guidelines on who should receive germline and somatic testing, and notes that approved somatic therapies, including PARP inhibitors for BRCA1 and 2 and immunotherapy for microsatellite instability-high tumors, are only available to patients who have tested positive for the relevant mutations, underscoring the importance of widespread testing. Dr. Bryce also emphasizes the importance of germline testing for the patient’s family members, since the knowledge that they carry a hereditary cancer risk gene may allow them to receive early, life-saving cancer diagnoses. The presentation concludes with a Q&A session with E. David Crawford, MD, Professor of Urology at the University of California, San Diego, during which Drs. Crawford and Bryce discuss the limitations of taking a family history and how reimbursement works for multiple genetic tests.

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Point-Counterpoint: There is a Role for Currently Available Biomarkers/Genomics in the Risk Stratification of Prostate Cancer

E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology, and Alan H. Bryce, MD, Chair of the Division of Hematology and Medical Oncology and Assistant Professor of Medicine at the Mayo Clinic in Phoenix, Arizona, present a Point-Counterpoint on the relative value of genomics and biomarkers in prostate cancer risk stratification. Dr. Crawford, presenting the pro side, argues that doctors need to do biomarker testing to know which patients to biopsy, follow closely, and treat with radiation. Dr. Bryce, presenting the con side, contends that while germline testing is beneficial, other biomarker tests have inconsistent results for prostate cancer patients.

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