PARP inhibitors have demonstrated benefit in mCRPC as monotherapy both before and after taxane therapy when patients have progressed on either abiraterone or enzalutamide.

What are your thoughts about future trials and combinations of PARP inhibitors or moving these therapies earlier within prostate cancer treatment?

Definitely I think for patients with germline alterations we should try to use these PARP inhibitors earlier. I don’t know whether they could have any role as adjuvant treatment but we know from several studies that patients with germline BRCA2 mutations have a very poor prognosis. We now have this option of targeted therapies so definitely. I don’t know whether it should have to be in combination with something else or just in monotherapy or for how long. We need trials to address all these questions then we need to move PARP inhibitors to earlier stages. At least for these patients.

For combinations of PARP inhibitors there are plenty of clinical trials running at present combining different PARP inhibitors either with checkpoint inhibitors or with different androgen receptor signalling inhibitors for targeted populations, I mean patients with specific molecular alterations, or for all comers. It will be very interesting to see the results of all these trials.