Integrating Biomarker Testing and Emerging Targeted Therapies in mCSPC

In this episode, ‘Integrating Biomarker Testing and Emerging Targeted Therapies in mCSPC,’ the panelists explore how emerging targeted therapies are reshaping the treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) and the critical role of biomarker testing in identifying appropriate candidates for these approaches. The expert faculty discuss the growing importance of incorporating germline and somatic testing into routine clinical workflows, emphasizing that early and comprehensive testing is essential for identifying patients who may benefit from PARP inhibitor–based strategies and other biomarker-driven treatments.

The panel reviews recent data supporting PARP inhibitor combinations, highlighting how genomic alterations in homologous recombination repair pathways can help guide treatment selection and intensification. They discuss current challenges surrounding implementation, including testing rates, workflow integration, clinician familiarity with targeted therapies, and the need to develop confidence in managing associated toxicities. The panelists stress that identifying eligible patients is only the first step and that successful adoption requires multidisciplinary collaboration and appropriate support systems.

The expert faculty also examine findings from the CAPItello-281 trial evaluating capivasertib in combination with abiraterone for patients with PTEN-deficient mCSPC. They explain the biologic significance of PTEN loss, review the study’s use of immunohistochemistry to identify eligible patients, and discuss how increasing degrees of PTEN loss appear to be associated with a more aggressive disease phenotype. The panel highlights the potential of AKT pathway inhibition to address this unmet need while acknowledging that regulatory review and future implementation considerations remain ongoing. Throughout the discussion, the panel emphasizes that advances in molecular testing, targeted therapies, and multidisciplinary care will continue to drive more personalized treatment strategies and improve outcomes for patients with mCSPC.

The final episode in this series, ‘Incorporating Emerging Data Into mCSPC Care,’ features the panelists discussing how clinicians can apply comparative and emerging clinical data while recognizing the limitations of hypothesis-generating evidence. The expert faculty highlight the importance of individualized treatment decisions based on disease biology, patient comorbidities, access considerations, and evolving evidence in mCSPC.