Department of Internal Medicine, University of South Florida, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
Cells. 2019 Aug 9;8(8):860. doi: 10.3390/cells8080860.
The approval of upfront abiraterone for castration-sensitive prostate cancer and the approval of enzalutamide and apalutamide for non-metastatic castration-resistant prostate cancer have led to early utilization of potent androgen receptor (AR) signaling inhibitors in treating advanced prostate cancer. There is an unmet need to develop novel therapies beyond targeting AR signaling for metastatic castration-resistant prostate cancer (mCRPC). Poly (ADP-ribose) polymerase inhibitors (PARPi) belong to a class of targeted agents being developed for the treatment of homologous recombination repair (HRR) deficient tumors. Olaparib, rucaparib, niraparib, veliparib, and talazoparib were evaluated in early phase trials as a monotherapy for HRR-deficient mCRPC. Among them, olaparib and rucaparib have breakthrough designations for -mutated mCRPC. Phase II studies also reported clinical activity of the PARPi and abiraterone combination and the PARPi checkpoint inhibitor combination in HRR-intact mCRPC. Ongoing phase III trials are testing these combinations as frontline or later line treatments for mCRPC. This review summarizes the critical clinical data as well as ongoing clinical trials for developing PARPi in treating mCRPC.
阿比特龙用于治疗去势敏感型前列腺癌的批准,以及恩杂鲁胺和阿帕鲁胺用于治疗非转移性去势抵抗性前列腺癌的批准,导致在治疗晚期前列腺癌时早期使用强效雄激素受体 (AR) 信号抑制剂。对于转移性去势抵抗性前列腺癌 (mCRPC),除了靶向 AR 信号之外,还需要开发新的治疗方法。多聚(ADP-核糖)聚合酶抑制剂 (PARPi) 属于一类正在开发用于治疗同源重组修复 (HRR) 缺陷肿瘤的靶向药物。奥拉帕利、鲁卡帕利、尼拉帕利、维利帕利和他拉唑帕利在早期单药治疗 HRR 缺陷 mCRPC 的临床试验中进行了评估。其中,奥拉帕利和鲁卡帕利因 - 突变 mCRPC 获得了突破性的指定。II 期研究还报告了 PARPi 和阿比特龙联合以及 PARPi 检查点抑制剂联合在 HRR 完整的 mCRPC 中的临床活性。正在进行的 III 期试验正在测试这些联合疗法作为 mCRPC 的一线或二线治疗。这篇综述总结了开发 PARPi 治疗 mCRPC 的关键临床数据和正在进行的临床试验。
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