Guidelines for germline testing in prostate cancer have significantly expanded in recent years, according to Veda N. Giri, MD. This was the basis for a recent review on the current state of germline testing in prostate cancer.1
In an interview with Urology Times®, Giri outlined points of consensus and areas of disagreement across national and international guideline recommendations for germline testing. One main point of agreement, she notes, is that men with metastatic or advanced prostate cancer should be prioritized and considered for germline testing. This is due to a widespread recognition that these men tend to have higher rates of genetic mutations.
Giri is a professor of internal medicine in medical oncology, the director of the Cancer Genetics and Prevention Program at Yale Cancer Center Smillow Cancer Hospital, and the director of the Early Onset Cancer Program at Yale Cancer Center in New Haven, Connecticut.
Giri also explained that germline testing guidelines in the United States includes the subset of patients with a family history of disease. However, this recommendation is not consistent across guidelines.
“What we do notice is variability in these family history guidelines from even different bodies within the United States, but certainly international guidelines as well,” Giri added. “This is an area that we can really grow more in terms of how we can think about consistency across the family history spectrum for thinking of which men are eligible for genetic testing.”
REFERENCE
1. Loeb S, Vadaparampil ST, Giri VN. Germline testing for prostate cancer: current state and opportunities for enhanced access. EBioMedicine. 2025:116:105705. doi:10.1016/j.ebiom.2025.105705