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Emmanuel Antonarakis recommends germline and somatic testing for all metastatic prostate cancer patients. Dr. Antonarakis orders germline testing pre-emptively, reserving genetic counseling for pathogenic variants when first-degree relatives face 50% inheritance risk. Somatic testing uses primary prostate tumor in 80% of metastatic androgen pathway modulation-sensitive cases, as truncal mutations like BRCA2 and mismatch repair defects reside in original tumors. Circulating tumor DNA requires adequate tumor burden. In castration-resistant disease, double or triple tumor suppressor loss involving p53, PTEN, or RB1 indicates poor prognosis and neuroendocrine transformation risk.
Emmanuel Antonarakis | Masonic Cancer Center
Administrative support contact for Dr. Antonarakis: Ms. J Knapp Dr. Antonarakis is the Clark Endowed Professor of Medicine, and a genitourinary medical oncologist with a particular focus on recurrent and advanced prostate cancer. He conducts clinical and translational studies to bring new...
Emmanuel Antonarakis recommends germline and somatic testing for all metastatic prostate cancer patients. Dr. Antonarakis orders germline testing pre-emptively, reserving genetic counseling for pathogenic variants when first-degree relatives face 50% inheritance risk. Somatic testing uses primary prostate tumor in 80% of metastatic androgen pathway modulation-sensitive cases, as truncal mutations like BRCA2 and mismatch repair defects reside in original tumors. Circulating tumor DNA requires adequate tumor burden. In castration-resistant disease, double or triple tumor suppressor loss involving p53, PTEN, or RB1 indicates poor prognosis and neuroendocrine transformation risk.
