Paul C. Boutros, PhD, MBA, professor in the Departments of Human Genetics and Urology at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), director of the UCLA Jonsson Comprehensive Cancer Center’s Cancer Data Science program, and associate director of cancer informatics at the UCLA Institute for Precision Health, discusses the utility of genetic testing in prostate cancer.

The role of genetic testing continues to expand in prostate cancer ​with updated guidelines and a number of ongoing ​clinical trials ​refining the utility of testing, Boutros says.

Notably, germline testing is critical if a patient has a strong family history of cancer. Moreover, if a patient has 

 metastatic, high-risk localized, or recurrent metastatic disease, genetic testing is indicated, Boutros adds.

Somatic testing, which evaluates the molecular complexity unique to individual tumor cells​, is also available. For example, the Decipher assay may have a role in managing patients with local disease​. ​However, the Decipher test is not required or used in the same abundance as germline testing, Boutros concludes.

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Paul C. Boutros, PhD, MBA, discusses the utility of genetic testing in prostate cancer.

Dr. Boutros on the Utility of Genetic Testing in Prostate Cancer

Paul C. Boutros, PhD, MBA, professor in the Departments of Human Genetics and Urology at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), director of the UCLA Jonsson Comprehensive Cancer Center’s Cancer Data Science program, and associate director of cancer informatics at the UCLA Institute for Precision Health, discusses processes that predict disease lethality in men with prostate cancer. 

Aggressive prostate cancer appears to be driven largely by 5 key factors, Boutros explains. 

The first is genomic instability, Boutros says. Tumors that harbor more mutations are more likely to be lethal.

Second, hypoxic tumors tend to be more aggressive compared with tumors that receive more oxygen, Boutros says. Non-hypoxic tumors act more like normal tissue and are therefore less lethal versus tumors that receive a low level of oxygen.

Additionally, patients with intraductal carcinoma with cribriform architecture have a more aggressive subhistology of prostate cancer, Boutros says.

A fourth factor is whether the tumor is visible by standard multiparametric MRI, says Boutros.

Finally, estimating the tumor’s evolution, including how clonal, complex, and branched the tumor’s evolutionary history is can provide insight into how lethal a patient’s disease is likely to be, concludes Boutros. 

Paul C. Boutros, PhD, MBA, discusses processes that predict disease lethality in men with prostate cancer.  


Paul C. Boutros, PhD, MBA

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Dr. Boutros on the Utility of Genetic Testing in Prostate Cancer

Dr. Boutros on Processes That Predict Lethality in Prostate Cancer