Familial Hereditary Prostate Cancer: Genetic, Screening, and Treatment Strategies
Genetic testing for prostate cancer (PrCa) has become more common in clinical practice due to the availability of targeted therapies for specific subgroups based on genetic characteristics. This requires examining multiple genes to enable more precise treatment sequences. Identifying hereditary PrCa can guide treatment decisions and impact cancer screening for patients and their relatives. Some mutations discovered through genetic testing may be hereditary, thus requiring germline testing from normal tissue within the framework of clinical counseling. Germline testing can provide valuable information for PrCa patients in terms of treatment options and screening for other cancers in their relatives. Guidelines suggest genetic testing for all individuals with metastatic PrCa and also consider family history and tumor features for broader testing criteria. BRCA2, the gene most strongly linked to inherited PrCa, is associated with poorer survival outcomes when deficient. Targeted therapies such as poly-ADP ribose polymerase inhibitors and platinum-based chemotherapy have shown promise in treating cancer cells with BRCA1/2 deficiencies. The increasing role of genetic testing in PrCa indicates the necessity to expand its indications and consider treatment implications for metastatic PrCa patients, as well as cancer risk assessment for early-stage disease. The collaboration of experts in molecular pathology, bioinformatics, biology, and genetic counseling is vital for the evolving landscape of PrCa care.
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