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2019 PCF VAlor Challenge Award

Technology-enhanced AcceleRation of Germline Evaluation for Therapy – The TARGET study

Principal Investigators: Veda Giri, MD (Thomas Jefferson University), Stacy Loeb, MD (New York University)

Co-Investigators: Amy Leader, PhD (Thomas Jefferson University), Scott Keith, PhD, (Thomas Jefferson University), Philip Massey, PhD (Drexel University), Colette Hyatt, MS (Thomas Jefferson University), Heather Cheng, MD, PhD (University of Washington)

Description:

  • Approximately 12% of men with metastatic prostate cancer harbor inherited mutations in DNA damage repair (DDR) genes, such as BRCA1 and BRCA2, which likely drove the development of their disease.
  • Based on these findings, NCCN guidelines now recommend genetic counseling and genetic testing for cancer risk genes in all men with metastatic prostate cancer, all men with unfavorable intermediate risk to high risk prostate cancer, men with Gleason score >=7 of Ashkenazi Jewish ancestry, and men with lower risk disease based upon family history. These recently expanded criteria have resulted in significant knowledge, practice, and awareness gaps regarding genetic testing for prostate cancer at the provider, patient, and population levels.
  • Veda Giri and team propose to comprehensively assess technology-based solutions to address these knowledge, practice, and awareness gaps regarding genetic testing for men with prostate cancer.
  • The team will identify provider-based barriers and facilitators to implementation of genetic counseling and testing for men with prostate cancer by performing interviews with medical oncologists, radiation oncologists and urologists across practice settings.
  • The team is developing a genetics mobile app for providers which has educational modules on prostate cancer genetic counseling and testing and includes a decision-support tool to identify men with prostate cancer who meet NCCN guidelines for genetic testing. The team will test the quality and performance of the app with urologists, medical and radiation oncologists, and will use feedback to refine the app.
  • The team will develop an interactive, multimedia web-based pretest genetic education (WBGE) tool for patients and conduct a randomized trial comparing this tool with traditional genetic counseling for facilitating informed and timely genetic testing for men with lethal/predicted lethal prostate cancer. The provider-based genetics mobile app will be used to aid physicians in identifying patients who should be accrued to this trial.
  • The team will develop and test social media strategies and ad campaigns to educate and increase public awareness about prostate cancer genetics.
  • If successful, this project will develop mobile and web-based tools to educate physicians, patients and the public on prostate cancer genetics and facilitate timely identification of men with prostate cancer who meet NCCN guidelines for genetic testing.

What this means to patients: A significant number of men with prostate cancer carry inherited cancer risk genes which drove the development of their disease. Dr. Giri and team will develop tools to educate physicians, patients and the public on prostate cancer genetics and identify patients who should undergo genetic counseling and testing. These studies will improve outcomes for patients and their families as identification of inherited cancer risk genes can inform precision treatment selection for prostate cancer patients and identify families at increased risk for prostate and other cancers.