PARP inhibitors in prostate cancer: Choices of tests and how to test?

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Published: 11 Jun 2020
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Dr Kim Chi and Dr Alexander Wyatt

Dr Kim Chi (BC Cancer Research Centre, Vancouver, Canada) and Dr Alexander Wyatt (Vancouver Prostate Center, Vancouver, Canada) discuss the use of PARP inhibitors for the treatment of advanced prostate cancer, including the role genetic testing in these patients.

The experts provide an overview of the genomic aberrations found in the DNA damage repair pathways that underlie most cases of advanced prostate cancer - in which PARP inhibitors can target effectively. Dr Chi states that there are currently two FDA-approved PARP inhibitors (olaparib and rucaparib) for the treatment of metastatic castration-resistant prostate cancer (mCRPC), based on the results from the PROfound and TRITON2 studies respectively.

Dr Chi and Dr Wyatt go on to discuss which patients should be tested and the challenges associated with carrying out these tests. Dr Wyatt states that tissue testing remains the gold standard currently, but the use of circulating tumour DNA (ctDNA) to detect genomic alterations looks promising for the future.

The experts conclude by explaining the next steps if a negative or positive test is achieved, along with the implications of further germline testing in this patient population.

This programme has been supported by an unrestricted educational grant from AstraZeneca.