To the Editor We read with interest the article by Nicolosi et al1 on germline variants in patients with prostate cancer. However, we wish to express reservations that go beyond the fact that all authors but 1 were employees, grant recipients, or shareholders of Invitae, a fast-growing US genetic information company. The authors claim to have studied unselected patients. This is incorrect. These were by definition highly selected patients because DNA was sent to Invitae owing to suspected genetic susceptibility. eTable 1 in the Supplement of the article1 demonstrates the importance of family history: for example, among the 3607 patients included, there were 3754 family history occurrences of BRCA1/2-associated cancer (breast, ovary, prostate, pancreas). The relatively high rate of germline variants in this context is hardly surprising. Furthermore, family history was solely based on the information the ordering physician was willing to provide and is thus likely incomplete.
Benusiglio PR, Korenbaum C, Coulet F. Germline Variants in Highly Selected Patients With Prostate Cancer. JAMA Oncol. Published online July 11, 2019. doi:10.1001/jamaoncol.2019.2106
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