Nogueira Costa Inês, Reis Joana, Meireles Sara, Ribeiro Maria João, Barbosa Miguel, Augusto Isabel
Medical Oncology Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.
Eur J Case Rep Intern Med. 2022 May 24;9(5):003331. doi: 10.12890/2022_003331. eCollection 2022.
Prostate cancer is the second most frequent malignancy in men worldwide. Despite the improvement in survival achieved by increasingly early diagnosis and advances in treatment, it is still associated with high mortality. Because of its molecular heterogeneity, there is a need to identify genetic alterations in order to apply targeted therapies. Increasing evidence suggests that the PARP inhibitor olaparib could have a significant synthetic lethal effect in prostate cancer with homologous recombination defects, such as BRCA1/2 mutations. It is not yet known if, under these circumstances, platinum-based chemotherapy induces higher response rates in prostate cancer. We present the case of a patient with BRCA2-mutated metastatic castration-resistant prostate cancer whose treatment sequence included carboplatin and olaparib.
Metastatic castration-resistant prostate cancer (mCRPC) remains a lethal disease despite significant progress in treatment.The BRCA2 mutation is associated with worse survival and so timely genetic screening is important.Studies are needed to identify the best therapeutic sequencing strategy for mCRPC harbouring homologous recombination repair defects, which includes PARP inhibitors and platinum.
前列腺癌是全球男性中第二常见的恶性肿瘤。尽管早期诊断的不断改进和治疗的进展使生存率有所提高，但它仍然与高死亡率相关。由于其分子异质性，需要识别基因改变以便应用靶向治疗。越来越多的证据表明，聚（ADP-核糖）聚合酶（PARP）抑制剂奥拉帕利在具有同源重组缺陷（如BRCA1/2突变）的前列腺癌中可能具有显著的合成致死效应。目前尚不清楚在这些情况下，铂类化疗是否能在前列腺癌中诱导更高的缓解率。我们报告一例BRCA2突变的转移性去势抵抗性前列腺癌患者，其治疗方案包括卡铂和奥拉帕利。
尽管治疗取得了显著进展，但转移性去势抵抗性前列腺癌（mCRPC）仍然是一种致命疾病。BRCA2突变与较差的生存率相关，因此及时进行基因筛查很重要。需要开展研究以确定针对具有同源重组修复缺陷的mCRPC的最佳治疗序贯策略，其中包括PARP抑制剂和铂类药物。
