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SIUrO best practice recommendations to optimize BRCA 1/2 gene testing from DNA extracted from bone biopsy in mCRPC patients (BRCA Optimal Bone Biopsy Procedure: BOP)

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Abstract

The main guidelines and recommendations for the implementation of the BRCA1/2 somatic test do not focus on the clinical application of predictive testing on bone metastases, a frequent condition in metastatic prostate cancer, by analyzing the critical issues encountered by laboratory practice. Our goal is to produce a document (protocol) deriving from a multidisciplinary team approach to obtain high quality nucleic acids from biopsy of bone metastases. This document aims to compose an operational check-list of three phases: the pre-analytical phase concerns tumor cellularity, tissue processing, sample preservation (blood/FFPE), fixation and staining, but above all the decalcification process, the most critical phase because of its key role in allowing the extraction of somatic DNA with a good yield and high quality. The analytical phase involves the preparation of the libraries that can be analyzed in various NGS genetic sequencing platforms and with various bioinformatics software for the interpretation of sequence variants. Finally, the post-analytical phase that allows to report the variants of the BRCA1/2 genes in a clear and usable way to the clinician who will use these data to manage cancer therapy with PARP Inhibitors.

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Authors and Affiliations

  1. Institute of Pathological Anatomy, Department of Medicine (DAME), University of Udine, Via Palladio 8, 33100, Udine, Italy

    Alessia Cimadamore

  2. Translational and Clinical Research Institute, Centre for Cancer, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK

    Pasquale Rescigno

  3. Candiolo Cancer Institute, FPO-IRCCS, 10060, Candiolo, Italy

    Pasquale Rescigno

  4. Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences - Policlinico Riuniti, University of Foggia, 71122, Foggia, Italy

    Vincenza Conteduca

  5. Department of Diagnostic and Public Health, Section of Pathology, University of Verona, Largo L. Scuro 10, 37134, Verona, Italy

    Anna Caliò

  6. Interventional radiology Unit, Azienda ospedaliera Santa Maria Terni, Viale Tristano di Joannuccio, 05100, Terni, Italy

    Massimiliano Allegritti

  7. Central Laboratory of Advanced Diagnosis and Biomedical Research, (CLADIBIOR) Policlinico Paolo Giaccone Hospital, University of Palermo, 90127, Palermo, Italy

    Valentina Calò

  8. Pathology Unit, USL Toscana Centro - Ospedale San Giuseppe, Empoli, Italy

    Ilaria Montagnani

  9. Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Roberta Lucianò

  10. Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori “Giovanni Paolo II,”, Bari, Italy

    Margherita Patruno

  11. Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera Santa Maria, Viale Tristano di Joannuccio, 05100, Terni, Italy

    Sergio Bracarda

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  1. Alessia Cimadamore
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on behalf of the Italian Society for Uro-Oncology (SIUrO)

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All authors contributed to data collection, drafting, writing, and editing of the manuscript. Alessia Cimadamore and Sergio Bracarda contributed to study conception and design. All authors read and approved the final manuscript.

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Correspondence to Alessia Cimadamore.

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Cimadamore, A., Rescigno, P., Conteduca, V. et al. SIUrO best practice recommendations to optimize BRCA 1/2 gene testing from DNA extracted from bone biopsy in mCRPC patients (BRCA Optimal Bone Biopsy Procedure: BOP). Virchows Arch 483, 579–589 (2023). https://doi.org/10.1007/s00428-023-03660-0

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