[Poly (ADP-ribose) polymerase inhibitor combination therapy in metastatic castration-resistant prostate cancer].

BACKGROUND

Metastatic castration-resistant prostate cancer (mCRPC) remains a therapeutic challenge. Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) combined with new hormonal agents (NHA) offer novel treatment options.

OBJECTIVE

This review summarizes the current status of PARPi + NHA combination therapy in mCRPC.

MATERIALS AND

METHODS

Summary of relevant phase II and III trials on PARPi + NHA and the G‑BA (Gemeinsame Bundesausschuss) decision as well as the current S3 guideline recommendations.

RESULTS

PARPi + NHA demonstrated improved efficacy compared to NHA alone in an all-comers population that received prior androgen deprivation therapy (ADT) or docetaxel therapy. In particular the subgroup of patients with homologous recombination repair (HRR) and breast cancer (BRCA) 1/2 mutations had the best outcomes. Olaparib + abiraterone, talazoparib + enzalutamide, and niraparib + abiraterone are approved combinations, expanding treatment options in mCRPC.

CONCLUSION

PARPi + NHA represent a significant advance in mCRPC therapy. Molecular genetic testing for HRR mutations, especially BRCA 1/2, is crucial for treatment planning.