The tip of the iceberg: predicting PARP inhibitor efficacy in prostate cancer
Mené au Royaume-Uni sur 98 patients atteints d'un cancer de la prostate résistant à la castration, de stade métastatique et présentant des aberrations des gènes DDR, cet essai de phase II évalue l'efficacité, du point de vue du taux de réponse confirmée, et la toxicité de l'olaparib (durée médiane de suivi : 24,8 mois)
In The Lancet Oncology, Joaquin Mateo and colleagues report the results of the TOPARP-B trial, in which selected patients with metastatic castration-resistant prostate cancer and DNA damage response (DDR) gene aberrations were found to be responsive to the poly(ADP–ribose) polymerase (PARP) inhibitor, olaparib. Their study adds to the growing body of prospective studies evaluating different PARP inhibitors in patients with metastatic castration-resistant prostate tumours that harbour DNA repair defects. The recently reported phase 3 PROFOUND study showed an improved radiographic progression-free survival for patients with DDR gene aberrations treated with olaparib, compared with a control group treated with physician's choice of therapy.These prospective studies are leading to a new era in which metastatic castration-resistant prostate cancer might have predictive, rather than prognostic, molecular markers to guide treatment decisions. Predictive assays are an important and innovative step in the treatment of metastatic prostate cancer. However, before we wholly embrace this approach, we should critically evaluate the outstanding issues, to improve precision in this changing treatment landscape. (...)
The Lancet Oncology , commentaire en libre accès, 2018