PARP inhibitors in metastatic prostate cancer: When, who, and how?

Abstract

Carcinoma prostate is among the most common cancers worldwide and is mainly treated in metastatic settings through androgen blockade or chemotherapy. Homologous repair deficiency is fairly common (germline and somatic) and allows targeted therapy through poly ADP-ribose polymerases (PARP) inhibitors. While data backing monotherapy is strong, recent evidence seems to support frontline combination therapy as well. Genetic testing of prostate cancer patients also needs personalization. Pre-clinical and early clinical data have provided insights into mechanisms and management of therapy resistance as well. This narrative review deals with the optimal patient selection and the evidence behind PARP inhibitor therapy in cases of metastatic carcinoma prostate.