PARP Inhibitors Will Add a Treatment Option for Men with Metastatic Prostate Cancer

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CURE, Genitourinary Cancers Special Issue 2020,

PARP inhibitors are not only expanding the field of prostate cancer but they're giving men another option for life after cancer.

The mainstay of treatment for metastatic prostate cancer has long involved suppression of the hormones that fuel the disease, and that strategy can spark a remission that lasts many years.

But in some cases, disease becomes resistant to these drugs and needs different modes of treatment. The good news is that the Food and Drug Administration recently approved two drugs that are new to prostate cancer treatment and could help nearly one-third of men with metastatic disease.

In May, both Lynparza (olaparib) and Rubraca (rucaparib), known as poly-ADP ribose polymerase (PARP) inhibitors, were approved to treat men with DNA repair problems that either developed in their tumors or were inherited in their genetic codes. At that time, we explained how these drugs kill cancer cells by augmenting their existing DNA repair glitches, making it more difficult for the cells to fix themselves when damaged. PARP is a protein involved in DNA repair, and these drugs work by inhibiting its activity.

In this special issue of CURE®, we bring you a more in-depth look at the advent of PARP inhibitors in the treatment of prostate cancer and what it will mean to patients. We discuss who may benefit and how these patients can be identified, what kind of responses and side effects can be anticipated and what questions patients should ask to ensure they will be offered these drugs if they are good candidates for the treatments.

Elsewhere in the magazine, we offer another feature on a recent drug approval in metastatic disease — in this case, urothelial cancer. While multiple immunotherapies known as checkpoint inhibitors have been approved to treat this type of bladder cancer since 2014, the recent approval of one such drug, Bavencio (avelumab), to be given just after initial treatment with platinum chemotherapy, is the first to be used in this earlier setting and spark an improvement in overall survival. In our article, we look at the survival benefits that are possible with this drug and the complex issue of how to determine who is most likely to benefit from it.

A third feature is devoted to an issue that is vitally important to survivors of prostate and bladder cancers: the sexual side effects that can arise from treatment. The article explores the best ways to manage these side effects when they cannot be avoided or reversed.

In a look at a rare cancer whose patients are affected by a lack of public awareness and research, we offer a section on penile cancer, including an interview with a caregiver and a conversation with an expert on clinical trials. Attention also is given to the ramifications of the COVID-19 pandemic in an article that suggests long-term adoption of some of the changes to kidney cancer care that have arisen from the crisis.

We hope these updates will leave you feeling better informed about therapies, research and side-effect management, helping you to make good decisions about your care both during and after treatment.

As always, thank you for reading.