Combining Poly(ADP)-Ribose Polymerase Inhibitors With Abiraterone in Castration-Resistant Prostate Cancer: Is Biomarker Testing Necessary?
Mené sur 670 patients atteints d'un cancer de la prostate résistant à la castration et de stade métastatique, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité de l'ajout du niraparib à un traitement combinant acétate d'abiratérone et prednisone, selon la présence d'altérations au niveau des gènes liés à la recombinaison homologue (dont les altérations des gènes BRCA1/2)
In May 2020, the US Food and Drug Administration approved two poly(ADP)-ribose polymerase (PARP) inhibitors for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Olaparib was approved for patients with mCRPC who harbor a deleterious germline or somatic mutation in one of the 14 homologous recombination repair (HRR)–associated genes (BRCA1 and BRCA2 plus 12 others: ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, RAD51B, RAD51C, RAD51D, or RAD54L) and who have previously received treatment with an androgen receptor (AR)–directed agent, on the basis of an overall radiographic progression-free survival (rPFS) benefit seen in the PROfound study.1 In addition, rucaparib was approved for patients with mCRPC with deleterious germline or somatic BRCA1 or BRCA2 mutations who have previously received AR-directed therapy and taxane-based chemotherapy, on the basis of favorable objective radiographic responses observed in the TRITON2 study.2 Both indications require biomarker testing, opening the door to a precision oncology approach for the management of mCRPC.
Journal of Clinical Oncology , éditorial, 2022