未经批准:前列腺癌(PCa)的生殖系和肿瘤基因检测正在被广泛接受,但是在每个疾病阶段对携带者的适应症和临床后果的测试还没有很好的定义。
UNASSIGNED:确定荷兰多学科专家小组关于PCa中种系和肿瘤基因检测的适应症和应用的共识。
UNASSIGNED:该小组由参与PCa管理的39名专家组成。我们使用了一种改进的Delphi方法,该方法由两轮投票和一次虚拟共识会议组成。
UNASSIGNED:如果≥75%的小组成员选择了相同的选择,则达成了共识。通过RAND/UCLA适当性方法评估适当性。
未经评估:在多项选择题中,44%达成共识。对于有相关家族史(家族性PCa/BRCA相关遗传性癌症)的无PCa男性,前列腺特异性抗原的随访被认为是合适的.对于低风险的局部PCa和有PCa家族史的患者,积极监测被认为是适当的,除非患者是BRCA2种系致病变异携带者。在没有相关癌症家族史的情况下,不应对非转移性激素敏感性PCa进行种系和肿瘤基因检测。肿瘤基因检测被认为最适合识别可行的变异,种系测试的不确定性。对于转移性去势抗性PCa的肿瘤基因检测,时间安排和小组组成未达成共识.主要局限性如下:(1)讨论的许多主题缺乏科学证据,因此,这些建议部分是基于意见的,(2)每个学科的专家人数很少。
UNASSIGNED:本次荷兰共识会议的结果可能为与PCa相关的遗传咨询和分子检测提供进一步的指导。
UNASSIGNED:一组荷兰专家讨论了在前列腺癌(PCa)患者中使用种系和肿瘤基因检测,这些测试的适应症(哪些患者和何时),以及这些测试对PCa管理和治疗的影响。
UNASSIGNED: 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.
UNASSIGNED: To determine the
consensus of a Dutch multidisciplinary expert panel on the indication and application of germline and tumour genetic testing in PCa.
UNASSIGNED: 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.
UNASSIGNED: Consensus was reached if ≥75% of the panellists chose the same option. Appropriateness was assessed by the RAND/UCLA appropriateness method.
UNASSIGNED: 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.
UNASSIGNED: The outcomes of this Dutch consensus meeting may provide further guidance on genetic counselling and molecular testing related to PCa.
UNASSIGNED: 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.