Dr. Chang on the Use of PARP Inhibitors in Prostate Cancer

Sam S. Chang, MD, MBA, professor, Department of Urology, Patricia and Rodes Hart Endowed Chair of Urologic Surgery, Vanderbilt University Medical Center, discusses the shift toward personalized therapy in prostate cancer.

In the phase III PROfound trial, the PARP inhibitor olaparib (Lynparza)led to an improvement in radiographic progression-free survivalversus enzalutamide (Xtandi) or abiraterone acetate (Zytiga) in men with metastatic castration-resistant prostate cancer with homologous recombination repair gene alterations. Though, the benefit was more pronounced in patients with BRCA1/2 and ATM alterations.

Historically, genetic testing has not played a large role in the treatment of patients with prostate cancer, explains Chang. Urologists typically focused on tumor grade and Gleason score rather than molecular alterations. Now, genetic testing could inform systemic therapy options for patients, concludes Chang.