Don's Home Health Cause of Death Cancer Prostrate GUNS Trial

The Genomic-biomarker-selected Umbrella Neoadjuvant Study (GUNS) is a multicenter, adaptive phase II clinical trial led by Dr. Martin Gleave at the Vancouver Prostate Centre, designed to improve outcomes for patients with high-risk localized prostate cancer (HRLPC).
The trial utilizes a precision oncology approach by sequencing patient tumor biopsies or blood to match specific genomic alterations with targeted neoadjuvant therapies (cancer treatments administered before the primary treatment,) administered prior to radical prostatectomy.

Patients receive an initial 8-week course of androgen deprivation therapy (ADT) plus apalutamide while their tumor DNA and RNA are sequenced.

Tempus is a lab which does genetic analysis from a blood sample, which they can use.
Patients are assigned to one of 6 (as of 2026) trial protocols.

GUNS (Genomic biomarker-selected umbrella neoadjuvant study for high risk localized prostate cancer) Trail | Vancouver Prostrate Center 2026

Results of sub-protocol 1 of the Genomic Umbrella Neoadjuvant Study (GUNS) trial - 2025 ASCO (American Society of Clinical Oncology) Symposium AI response from Google Search:
For patients with high-risk localized prostate cancer.

Trial Design: The study utilizes a precision oncology approach where patients receive an initial 8-week course of androgen deprivation therapy (ADT) plus apalutamide while their tumor DNA and RNA are sequenced.
Biomarker-Driven Allocation: Based on genomic profiling, patients are assigned to specific sub-protocols: AR-associated alterations (e.g., ETS fusions, FOXA1, SPOP): Randomized to receive either the doublet therapy or a triplet adding abiraterone. Aggressive tumor suppressor loss (e.g., RB1, PTEN, TP53): Assigned to receive docetaxel chemotherapy. DNA repair deficiencies (e.g., BRCA): Treated with the PARP inhibitor niraparib. Immunogenic alterations (e.g., MMR deficiency): Treated with the PD-L1 inhibitor atezolizumab.

The earliest reference I could find was in the 1919 SUO (Society of Urologic Oncologuy) Annual meeting, so it's been around at least 6 years. My Precision Oncology Program (MyPOP)| Vancouver Prostate Center
The Vancouver Prostate Centre's MyPOP (My Precision Oncology Program) is a recently launched clinical research program which strives to better deliver personalized therapeutics to patients with advanced or treatment-resistant cancer of the prostate, kidney or bladder. The program is currently available only to patients of the VPC or BCC who meet specific clinical trial criteria. The program's objectives are to:

• Develop standardized procedures to enable routine linking of genomic sequencing data with clinical decision making,
• Integrate research and development of plasma DNA and RNA assays into clinical practice, and
• Integrate clinical information with novel model systems

LRH - Luteinizing hormone-releasing hormone (also called LHRH analogs or GnRH (Gonadatropin Releasing Hormone) agonists) are drugs that lower the amount of testosterone made by the testicles.