Looking at my data in the vault should I get genetic testing

Based on your health summary, you have already undergone several types of genetic and genomic testing, including:

1. Tempus xT genomic sequencing, which found:

• Two significant mutations in the KMT2D gene
• Low tumor mutational burden (2.37 mut/Mb)
• No MSI-High status detected

1. Guardant360 testing (multiple times):

• Most recent in June 2024 was negative for reportable somatic alterations
• Low tumor fraction (<0.05%) on liquid biopsy

1. Germline genetic testing:

• No pathogenic germline variants were identified
• You also have 23andMe genetic data available

According to NCCN Guidelines for Prostate Cancer (2023), genetic testing is recommended for patients with:

• High-risk, very high-risk, regional, or metastatic prostate cancer
• Gleason score ≥7 Your Gleason 9 score and disease characteristics fit these criteria, but you've already completed comprehensive testing.

The American Society of Clinical Oncology (ASCO) guidelines suggest that patients with your profile should have both somatic (tumor) and germline testing, which you have already completed through multiple platforms.

Recommendation: Rather than additional genetic testing at this time, focus on:

1. Regular monitoring of your existing genomic markers
2. Discussing the KMT2D mutations found with your oncology team for potential targeted therapy options
3. Continuing with your current surveillance program using Signatera and other monitoring tools

Always consult with your healthcare team before making any medical decisions, as they may have additional insights based on your complete medical history.