Barbados’ first next-generation sequencing of a prostate cancer sample.

Abstract

5025 Background: According to the WHO (2022), Prostate cancer is the most frequent of all cancers in Barbados. In 2022, it accounted for over 45% of the reported cancer cases on the island, second being colorectal cancer at an alarming, contrasted prevalence rate of 13.5%. Today, cancer is fought at the cellular level across the globe. Reportedly nearly 40% of prostate cancer may be attributed to inherited genetic susceptibility, yet only hand full of clinically relevant genes have been associated with risk and/or adverse outcomes after diagnosis with this type of cancer (NCI, 2025). NGS is not widely available in Barbados. The primary aim of this research was to evaluate the feasibility of providing Next Generation Sequencing capability to the patients and practitioners on the island and to discover more about the genomics of the prostate cancer present on the island at molecular, ethnic, and geographic levels. Methods: A genomic sequencing protocol was conducted to determine the feasibility of delivering Next Generation Sequencing to patients receiving oncological care on the island. A Barbadian multidisciplinary team inclusive of a pathology group, prostate cancer surgical center and healthcare system partnered with their South American medical equipment distributor and a global genomics and human health innovation company to conduct the pilot study. Forty prostate cancer archive tissue samples were identified from a local tissue bank. The samples were donated to future use research by previously treated surgical cases. Patients provided written consent to future use research. Of the forty samples, 25 were batched and shipped to a genomics laboratory for DNA extraction. DNA was then shipped to Illumina Laboratories in Baltimore where the NGS sequencing was performed. The OncoReveal Multi-Cancer with CNV & RNA Fusion Panel on the Illumina MiniSeq system was utilized. Results: OncoReveal Multi-Cancer with CNV & RNA Fusion Panel had the capability to detect 60 variants and CNVs detected from DNA. Of the 25 cases sequenced, new actionable data were found on 52% (13 of 25) with 33.3% (3 of 12) of tests detecting a ATM. The remaining data found following variants APC, CDKN2A, JAK3 V722I, PIK3CA, TP53, PTEN, SMO, CDKN2A, TP53, ERBB2 and PTEN. All of which were 7.6% (1of 13) in therapeutics actionability. Conclusions: Next Generation Sequencing in Barbadian men is not performed as part of routine diagnostic care due to a lack of access to this companion diagnostic resource. Providing NGS to local patients was proven to be feasible utilizing a central laboratory transport and testing model. OncoReveal Panel performed on a random sample revealed new actionable data were found on 52% (13 of 25) with 33.3% (3 of 12) of tests detecting a ATM. This suggests approximately 50% of this male population may find clinical utility in the use of NGS as a companion diagnostic and more research is needed in the region to better understand the high prevalence of the ATM variant.