European Urology Open Science (Mar 2023)
Genetic Aspects and Molecular Testing in Prostate Cancer: A Report from a Dutch Multidisciplinary Consensus Meeting
- Niven Mehra,
- Iris Kloots,
- Michiel Vlaming,
- Shafak Aluwini,
- Els Dewulf,
- Daniela E. Oprea-Lager,
- Henk van der Poel,
- Herman Stoevelaar,
- Derya Yakar,
- Chris H. Bangma,
- Elise Bekers,
- Roderick van den Bergh,
- Andries M. Bergman,
- Franchette van den Berkmortel,
- Steve Boudewijns,
- Winand N.M. Dinjens,
- Jurgen Fütterer,
- Tom van der Hulle,
- Guido Jenster,
- Leonie I. Kroeze,
- Michel van Kruchten,
- Geert van Leenders,
- Pim J. van Leeuwen,
- Wendy W.J. de Leng,
- R. Jeroen A. van Moorselaar,
- Walter Noordzij,
- Rogier A. Oldenburg,
- Inge M. van Oort,
- Irma Oving,
- Jack A. Schalken,
- Ivo G. Schoots,
- Ed Schuuring,
- Robert J. Smeenk,
- Ben G.L. Vanneste,
- Erik Vegt,
- André N. Vis,
- Kim de Vries,
- Peter-Paul M. Willemse,
- Maurits Wondergem,
- Margreet Ausems
Affiliations
- Niven Mehra
- Department of Medical Oncology, Radboud UMC, Nijmegen, The Netherlands; Corresponding author. Department of Medical Oncology, Radboud University Medical Centre, Postbus 9101, 6500 HB Nijmegen, The Netherlands. Tel. +31 243610354; Fax: +31 243615025.
- Iris Kloots
- Department of Medical Oncology, Radboud UMC, Nijmegen, The Netherlands
- Michiel Vlaming
- Division Laboratories, Pharmacy and biomedical Genetics, Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
- Shafak Aluwini
- Department of Radiation Oncology, UMCG, Groningen, The Netherlands
- Els Dewulf
- Centre for Decision Analysis & Support, Ismar Healthcare NV, Lier, Belgium
- Daniela E. Oprea-Lager
- Department of Radiology & Nuclear Medicine, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Henk van der Poel
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Herman Stoevelaar
- Centre for Decision Analysis & Support, Ismar Healthcare NV, Lier, Belgium
- Derya Yakar
- Department of Radiology, UMCG, Groningen, The Netherlands; Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Chris H. Bangma
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
- Elise Bekers
- Department of Pathology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Roderick van den Bergh
- Department of Urology, St. Antonius Ziekenhuis Nieuwegein, The Netherlands
- Andries M. Bergman
- Department of Medical Oncology and Oncogenomics, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Franchette van den Berkmortel
- Department of Internal Medicine, Zuyderland MC, Sittard, The Netherlands
- Steve Boudewijns
- Department of Medical Oncology, Bravis Hospital, Roosendaal, The Netherlands
- Winand N.M. Dinjens
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
- Jurgen Fütterer
- Department of Medical Imaging, Radboud UMC, Nijmegen, The Netherlands
- Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
- Guido Jenster
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
- Leonie I. Kroeze
- Department of Pathology, Radboud UMC, Nijmegen, The Netherlands
- Michel van Kruchten
- Department of Medical Oncology, University Medical Centre Groningen, Groningen, The Netherlands
- Geert van Leenders
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
- Pim J. van Leeuwen
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Wendy W.J. de Leng
- Department of Pathology, UMC Utrecht, Utrecht, The Netherlands
- R. Jeroen A. van Moorselaar
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Walter Noordzij
- Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
- Rogier A. Oldenburg
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
- Inge M. van Oort
- Department of Urology, Radboud UMC, Nijmegen, The Netherlands
- Irma Oving
- Department of Internal Medicine, Ziekenhuis Groep Twente, Almelo, The Netherlands
- Jack A. Schalken
- Department of Urology, Radboud UMC, Nijmegen, The Netherlands
- Ivo G. Schoots
- Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands; Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Ed Schuuring
- Department of Pathology, University Medical Center Groningen, Groningen, The Netherlands
- Robert J. Smeenk
- Department of Radiation Oncology, Radboud UMC, Nijmegen, The Netherlands
- Ben G.L. Vanneste
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht UMC, Maastricht, The Netherlands; Department of Human Structure and Repair, Ghent University Hospital, Ghent, Belgium; Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
- Erik Vegt
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- André N. Vis
- Department of Urology, Amsterdam University Medical Centers, VU University, Amsterdam, The Netherlands
- Kim de Vries
- Department of Radiation Oncology, Erasmus MC, Rotterdam, The Netherlands
- Peter-Paul M. Willemse
- Department of Urology, Cancer Center, UMC Utrecht, Utrecht, The Netherlands
- Maurits Wondergem
- Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands
- Margreet Ausems
- Division Laboratories, Pharmacy and biomedical Genetics, Department of Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
- Journal volume & issue
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Vol. 49
pp. 23 – 31
Abstract
Background: Germline and tumour genetic testing in prostate cancer (PCa) is becoming more broadly accepted, but testing indications and clinical consequences for carriers in each disease stage are not yet well defined. Objective: To determine the consensus of a Dutch multidisciplinary expert panel on the indication and application of germline and tumour genetic testing in PCa. Design, setting, and participants: The panel consisted of 39 specialists involved in PCa management. We used a modified Delphi method consisting of two voting rounds and a virtual consensus meeting. Outcome measurements and statistical analysis: Consensus was reached if ≥75% of the panellists chose the same option. Appropriateness was assessed by the RAND/UCLA appropriateness method. Results and limitations: Of the multiple-choice questions, 44% reached consensus. For men without PCa having a relevant family history (familial PCa/BRCA-related hereditary cancer), follow-up by prostate-specific antigen was considered appropriate. For patients with low-risk localised PCa and a family history of PCa, active surveillance was considered appropriate, except in case of the patient being a BRCA2 germline pathogenic variant carrier. Germline and tumour genetic testing should not be done for nonmetastatic hormone-sensitive PCa in the absence of a relevant family history of cancer. Tumour genetic testing was deemed most appropriate for the identification of actionable variants, with uncertainty for germline testing. For tumour genetic testing in metastatic castration-resistant PCa, consensus was not reached for the timing and panel composition. The principal limitations are as follows: (1) a number of topics discussed lack scientific evidence, and therefore the recommendations are partly opinion based, and (2) there was a small number of experts per discipline. Conclusions: The outcomes of this Dutch consensus meeting may provide further guidance on genetic counselling and molecular testing related to PCa. Patient summary: A group of Dutch specialists discussed the use of germline and tumour genetic testing in prostate cancer (PCa) patients, indication of these tests (which patients and when), and impact of these tests on the management and treatment of PCa.