Dr. Grivas on the Role of Targeted Therapy in Prostate Cancer

Petros Grivas, MD, PhD, physician, Seattle Cancer Care Alliance; associate professor, Department of Medicine, Division of Oncology and clinical director of the Genitourinary Cancers Program, University of Washington School of Medicine; and associate member, Clinical Research Division, Fred Hutchinson Cancer Center, discusses the role of targeted therapy in prostate cancer.

In the era of next-generation sequencing, translational research and clinical trials are often aimed at identifying actionable targets for novel therapies, explains Grivas.

Androgen receptor—targeting therapies like abiraterone acetate (Zytiga), enzalutamide (Xtandi), apalutamide (Erleada), and darolutamide (Nubeqa) have been a mainstay of treatment in metastatic hormone-sensitive prostate cancer and nonmetastatic castration-resistant prostate cancer (CRPC).

PARP inhibitors like olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) have shown activity in metastatic CRPC, says Grivas. Genomic data may aid in identifying patients with BRCA2 mutations who are likely to respond to PARP inhibition.

Patients with other mutations such as BRCA1 may also be suited for PARP inhibition, says Grivas. However, germline and somatic testing should be utilized for all patients to optimize patient selection. Additionally, test results should be reviewed by a molecular tumor board and genetic counselors when possible, concludes Grivas.