Abstract IA004: Moving the needle: It is time for universal germline and somatic genetic testing in all colorectal cancer patients


 The rapid evolution and commercialization of new techniques for analyzing DNA have extended our knowledge of inherited genetic abnormalities that can predispose a person to develop colorectal and other cancers. Concomitantly, the genetic fingerprinting of individual tumors has fueled the development of targeted therapies and informed their appropriate deployment for the management of individual patients. Recently, Cercek and colleagues at Memorial Sloan Kettering Cancer Center reported that all 14 patients with MSI-H rectal cancers treated in a clinical trial in the neoadjuvant setting with the PD-L1 inhibitor dostarlimab had complete remissions of their disease without chemotherapy, radiation, or surgery and those individuals are being followed to determine if, as hoped and expected, those remissions are durable (PMID:35660797). These insights have led and will continue to lead us to develop specific strategies to manage and minimize risk for affected individuals and their family members with inherited cancer susceptibility syndromes. They are also enabling us to decipher the practical value of the heterogeneity of colorectal cancers based upon the identification of inherited or acquired genetic abnormalities that drive the development and progression of an individual patient’s cancer. Now it is time to deploy germline and somatic genetic testing as a standard of care in the clinic, universally and equitably, for individualizing the assessment of inherited colorectal cancer susceptibility and for individualizing care in patients with colorectal cancer. Implementing this strategy will require resource allocation to ensure that health care teams and the patients that they care for both understand and derive the maximum possible benefit from implementing this new approach.
 Citation Format: Richard M. Goldberg. Moving the needle: It is time for universal germline and somatic genetic testing in all colorectal cancer patients [abstract]. In: Proceedings of the AACR Special Conference on Colorectal Cancer; 2022 Oct 1-4; Portland, OR. Philadelphia (PA): AACR; Cancer Res 2022;82(23 Suppl_1):Abstract nr IA004.