LUGPA 2025 Global Prostate Cancer Congress Enduring Program-GPCC 2025 Session 3

Video Transcription

Video Summary

The session focused on advances in genomics, biomarkers, imaging, and the microbiome in prostate cancer management. Dr. Todd Morgan reviewed the role of germline genetics—DNA mutations inherited from family—which affect prostate cancer risk and aggressiveness. Important genes include BRCA2, HOXB13, ATM, CHEK2, and others involved in DNA repair, with implications for earlier screening, prognosis, and targeted therapies such as PARP inhibitors. Polygenic risk scores, which aggregate many common DNA variants, help stratify risk and personalize screening schedules beyond family history.<br /><br />Dr. Gregorio discussed radiation oncology biomarkers, emphasizing prognostic tools like genomic classifiers (Decipher, Oncotype GPS, ATERA) that predict tumor aggressiveness and treatment response. Markers related to DNA damage, hypoxia, and immune response may improve radiation therapy planning and personalization, although clinical adoption is still evolving.<br /><br />Dr. Klotz presented data on MRI visibility of tumors, showing that genes driving MRI-visible prostate cancers overlap with those promoting aggressiveness. MRI-invisible tumors are generally less aggressive, suggesting MRI-targeted biopsies suffice for risk stratification, supporting more precise active surveillance and treatment decisions. Artificial intelligence and newer imaging techniques continue to enhance detection.<br /><br />Dr. Magi-Galluzzi addressed the emerging role of the microbiome, highlighting gut microbial composition's influence on prostate cancer risk and metabolism. Manipulating the microbiome via diet, prebiotics, probiotics, or engineered bacteria may offer future therapeutic avenues.<br /><br />Clinical cases illustrated integrating genomics, imaging, and biomarkers in treatment decisions, including ADT use, PSMA imaging, germline and somatic testing, and appropriate therapy selection, such as PARP inhibitors or immunotherapy for MSI-high cancers.<br /><br />An abstract on iso-PSA, a protein-structure assay, showed promise for prostate cancer detection in patients without MRI or with abnormal digital rectal exams, offering high sensitivity and negative predictive value to guide biopsy decisions.<br /><br />Overall, the session emphasized the growing role of genetics, imaging, biomarkers, and microbiome knowledge in personalizing prostate cancer screening, prognosis, and treatment.

Keywords

prostate cancer

genomics

biomarkers

microbiome

germline genetics

DNA repair genes

polygenic risk scores

radiation oncology biomarkers

MRI-visible tumors

artificial intelligence in imaging

PARP inhibitors