Prostate Cancer Patients May Benefit from Routine Tumor Genetic Testing, Study Suggests

Prostate Cancer Patients May Benefit from Routine Tumor Genetic Testing, Study Suggests
Implementation of routine tumor genetic testing may help identify the approximately 30% of men with metastatic castration-resistant prostate cancer (mCRPC) who may significantly benefit from targeted treatment, namely PARP inhibitors, an international study suggests. The results were presented in a poster, titled “Central, prospective detection of homologous recombination repair gene mutations (HRRm) in tumour tissue from >4000 men with metastatic castration-resistant prostate cancer (mCRPC) screened for the PROfound study,” at the European Society for Medical Oncology (ESMO) Congress 2019 that recently took place in Barcelona, Spain. Tumors of men with mCRPC can have damaging mutations in a variety of genes, including those involved in the process of homologous recombination (HR) in DNA repair. Among HR gene mutations, those in the BRCA1, BRCA2, and ATM genes are the most common, and they have been shown to be sensitive to PARP inhibitors in ovarian and breast cancer. PARP inhibitors selectively block the activity of the PARP enzyme, which acts as a DNA damage sensor, binding to the sites of DNA damage and leading to its repair. This type of treatment has been found to be particularly effective in cancer cells with defects in other DNA repair pathways — such as those with BRCA and ATM mutations — thus relying on PARP to survive and proliferate. This way, PARP suppression leads to the accumulation of DNA damage and ultimately to the death of these cancer cells. Interim results from the PROfound Phase 3 study (NCT02987543) — also presented at the ESMO congress — showed that Lynparza (olaparib), a PARP inhibitor, significantly delayed cancer progression in mCRPC patients with HR mutations, compared to standard treatment with Xtandi (en
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