Alexandra Sokolova, MD, discusses unanswered questions and next steps with PARP inhibitors in the prostate cancer treatment paradigm.
In this video, Alexandra Sokolova, MD, assistant professor of medicine, Division of Hematology/Medical Oncology, School of Medicine, Oregon Health & Science University, discusses remaining questions and next steps with PARP inhibitors in the prostate cancer treatment paradigm.
The biggest question is who should we be using it for? The FDA label for right now is for rucaparib (Rubraca) in second-line mCRPC for BRCA1/2-mutated patients, and for olaparib (Lynparza) in a broader homologous recombination repair (HRR) gene-mutated mCRPC population.
As far as first-line mCRPC, I think it's reasonable for BRCA1/2 carriers. I think we need to think more about who else should be benefiting and when. I think probably the next chapter would be more of combination therapies with PARP inhibitors. There are now newer PARP inhibitors coming on the market that are cleaner and potentially have a more tolerable side effect profile, making it easier to combine them. So using them in earlier stages is probably where I see the field going.
But I do think it's really important to use targeted therapies for targeted patient populations, and really invest in biomarker development and validation so we know who responds and why.
There are patients with mutations that do not respond and there are definitely patients without mutations that do respond. So, understanding of who they are and why this is happening is the key.
Transcript has been edited for clarity.