AstraZeneca’s Camille Hertzka: Testing for HRR Mutation Status in mCRPC Helps Inform Risk Profile

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Camille Hertzka, vice president, head of oncology, US Medical, AstraZeneca, discusses why it is important to test for HRR gene mutation status and appropriateness of olaparib use in patients with metastatic castrate-resistant prostate cancer (mCRPC).

Camille Hertzka, vice president, head of oncology, US Medical, AstraZeneca, discusses why it is important to test for HRR gene mutation status and appropriateness of olaparib use in patients with metastatic castrate-resistant prostate cancer (mCRPC).

Transcript

What are some common challenges when testing patients with mCRPC for HRR gene mutation status and olaparib?

The approval of olaparib in metastatic castrate-resistant prostate cancer [mCRPC] was in 2020 for patients harboring an HRR gene mutation; it was based on the PROfound study and has been really practice changing. The approval at the time led to a lot of excitement, as it was the introduction of precision medicine in prostate cancer. So that was really a new concept, especially in the advanced setting. And especially that was very important as it led to meaningful improvement for patients with this HRR mutation gene status.

HRR gene status can be done through 2 different approaches: It can be done through tissue or it can be done through blood. And when it’s done with blood, we use technology, which is called ctDNA [circulating tumor DNA] testing, which has a very strong advantage, especially for patients where archival tissue is not accessible or when the tissue biopsy is challenging to obtain. For example, with some patients with bone [metastasis], it’s not always easy to obtain a tissue biopsy. But with ctDNA, really that became much more easy to obtain samples and to do testing as well.

So we see both testing through tissue and through blood with ctDNA, depending on the situation. We also know that testing beyond informing for the PROfound regimen ... is very important to help inform patients on their overall prognostic and finding out risks, as we know that recommendation especially can be associated with finding out a risk.