Evaluation and Management of Localized and Recurrent Prostate Cancer: Genetic Cancer Profiling

Alan Pollack, MD, PhD, Professor and Chair in the Department of Radiation Oncology at University of Miami Health, looks at genetic cancer profiling for prostate cancer risk assessment and its implications for treatment. He begins with a discussion of the development of a habitat risk scoring system for prostate cancer which, via quantitative pixel by pixel assessment, can generate high-risk volumes for targeting. Dr. Pollack then moves on to transcriptome analysis using genomic classifiers like Decipher, noting that these classifiers have a relationship with Gleason score, though it is not absolute, and can predict 10-year distant metastasis. He also considers how to understand genomic risk of habitats from quantitative MRI, observing the significant connections between radiogenomic features and transcriptomic features. Dr. Pollack concludes with a discussion of how genomic signatures might influence critical management, going through how Decipher scores could change risk stratification and highlighting several trials looking at habitat targeted radiotherapy.

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