The new approaches to the treatment of castration- resistant prostate cancer: PARP inhibitors

• Main Authors: А. А. Gritskevich, I. G. Rusakov, Т. Р. Baitman, S. V. Mishugin
• Format: Article
• Language: Russian
• Published: Remedium Group LLC 2021-06-01
• Series: Медицинский совет
• Subjects: prostate cancer; metastatic castration- resistant prostate cancer; parp inhibitors; personalized medicine; olaparib for
• Online Access: https://www.med-sovet.pro/jour/article/view/6210
• ISSN: 2079-701X; 2658-5790

Prostate cancer (PC) is one of the leading causes of cancer death in the male population. Currently, the pathogenesis of prostate cancer has been studied in sufficient detail, which makes a successful radical treatment possible in most cases. However, in about 30% of patients traditional methods (e.g., radical prostatectomy, radiation therapy, androgen deprivation therapy – ADT, etc.) are ineffective, and castration- resistant (CRPC) and metastatic (mPC) types of РС are developing. Due to the advances in modern molecular oncology, various “workarounds”, genetic and epigenetic combinations, that allow РС to progress despite the absence of androgenic stimulation, are known nowadays. A personalized approach in oncology, which gradually becomes one of the standards for mCRPC therapy, allows not only to identify specific mutations, but also to select the most effective therapy for them in the most correct way. Now the most promising groups of the drugs for mCRPC treatment are poly(ADP-ribose)-polymerase (PARP) inhibitors, immune checkpoint inhibitors, and prostate- specific membrane antigen (PSMA) targeted therapy. This article attempts to summarize the current data on PARP inhibitors. The drugs of this group are especially effective for malignant neoplasms with mutations in the BRCA 1/2 genes, and successfully used in ovarian, breast and pancreatic cancer. They have been approved for the treatment of mCRPC a not so long ago. The advent of personalized companion tests has made the treatment of mCRPC more precise. Nowadays studies on the effectiveness of PARP inhibitors for mCRPC with other genetic and epigenetic changes, as well as in combination with other therapeutic agents, are notably actual.