Prostate Cancer Sees Surge of PARP Inhibition Strategies

In season 1, episode 4 of Targeted Talks, Michael Schweizer, MD, associate professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, spoke with fellow oncologist, Winston Tan, MD, medical oncologist and professor of medicine, Mayo Clinic, about the ever-changing treatment landscape for prostate cancer.

Historically, treatment of prostate cancer primarily consisted of chemotherapy as well as hormone therapy and anti-androgen receptor therapy. There were also agents introduced that demonstrated the ability to prevent metastatic disease in patients with prostate cancer. Lately, the field has shifted to a precision medicine model with new knowledge of the underlying mutations that drive this disease.

Contrary to the model of the past, it is now standard practice for oncologists to discuss genomic profiling with patients prior to deciding on treatment. The common mutations that oncologists have identified at this stage in care include BRCA1, BRCA2, and ATM, which are found in 20% to 30% of patients, according to Tan.

The introduction of PARP inhibitors in the prostate cancer treatment paradigm started a new evolution and as of today, 2 agents are FDA approved to treat patients with prostate cancer. What is unique about the approvals of both rucaparib (Rubraca) and olaparib (Lynparza) is that the studies supporting them (TRITON 2, NCT02952534; and PROfound, NCT02987543) were the first clinical trials in prostate cancer to use precision medicine practices, noted Schweizer.

Tan and Schweizer also discussed how to approach genomic testing in both community and academic settings, as well as the challenges that still exist with approaching precision medicine in prostate cancer.