Therapeutic implications of homologous repair deficiency testing in patients with prostate cancer (Part 2 of 2).

Unfortunately, not all metastatic castration-resistant prostate cancer (mCRPC) patients receive available life-prolonging systemic therapies, emphasizing the need to optimize mCRPC treatment selections. Better guidelines are necessary to determine genetic testing for prostate cancer.

In this two-part expert opinion-based guide, we provide an expert consensus opinion on the utilization of germline and somatic testing to detect HRR alterations in patients with mCRPC. This guide was developed by a multidisciplinary expert panel that convened in 2023-2024, including representatives from medical oncology, urology, radiation oncology, pathology, medical genomics, and basic science.

In this second part, we highlight how genetic testing can lead to improved, life-prolonging mCRPC therapeutic strategies based on a review of the recent phase III trials and subsequent regulatory approvals for PARP inhibitors in mCRPC.

Prostate cancer and prostatic diseases. 2024 Sep 27 [Epub ahead of print]

Anthony V Serritella, Amy Taylor, Michael C Haffner, Wassim Abida, Alan Bryce, Lawrence I Karsh, Scott T Tagawa, Przemyslaw Twardowski, Andrew J Armstrong, Joshua M Lang

University of Wisconsin, Madison, WI, USA., Fred Hutchinson Cancer Center, Seattle, WA, USA., Memorial Sloan Kettering Cancer Center, New York, NY, USA., Mayo Clinic Arizona, Phoenix, AZ, USA., The Colorado Urology Center, Denver, CO, USA., Weill Cornell Medicine, New York, NY, USA., Saint John's Cancer Institute, Santa Monica, CA, USA., Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University Medical Center, Durham, NC, USA., University of Wisconsin, Madison, WI, USA. .