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Background <p>Metastatic castration-resistant prostate cancer (mCRPC) remains a&#xa0;therapeutic challenge. Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) combined with new hormonal agents (NHA) offer novel treatment options.</p> Objective <p>This review summarizes the current status of PARPi +&#xa0;NHA combination therapy in mCRPC.</p> Materials and methods <p>Summary of relevant phase&#xa0;II and&#xa0;III trials on PARPi +&#xa0;NHA and the G‑BA (<i>Gemeinsame Bundesausschuss</i>) decision as well as the current S3&#xa0;guideline recommendations.</p> Results <p>PARPi +&#xa0;NHA demonstrated improved efficacy compared to NHA alone in an all-comers population that received prior androgen deprivation therapy (ADT) or docetaxel therapy. In particular the subgroup of patients with homologous recombination repair (HRR) and breast cancer (BRCA)&#xa0;1/2 mutations had the best outcomes. Olaparib +&#xa0;abiraterone, talazoparib +&#xa0;enzalutamide, and niraparib +&#xa0;abiraterone are approved combinations, expanding treatment options in mCRPC.</p> Conclusion <p>PARPi +&#xa0;NHA represent a&#xa0;significant advance in mCRPC therapy. Molecular genetic testing for HRR mutations, especially BRCA&#xa0;1/2, is crucial for treatment planning.</p>

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PARP-(Poly-Adenosindiphosphat-Ribose-Polymerase)Inhibitor-Kombinationstherapie beim metastasierten kastrationsresistenten Prostatakarzinom

  • 期刊论文

  • 发表日期：

    2025年12月16日

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  • Carsten Ohlmann,
  • Christian Gratzke,
  • Laura-Maria Krabbe

摘要

Background

Metastatic castration-resistant prostate cancer (mCRPC) remains a therapeutic challenge. Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPi) combined with new hormonal agents (NHA) offer novel treatment options.

Objective

This review summarizes the current status of PARPi + NHA combination therapy in mCRPC.

Materials and methods

Summary of relevant phase II and III trials on PARPi + NHA and the G‑BA (Gemeinsame Bundesausschuss) decision as well as the current S3 guideline recommendations.

Results

PARPi + NHA demonstrated improved efficacy compared to NHA alone in an all-comers population that received prior androgen deprivation therapy (ADT) or docetaxel therapy. In particular the subgroup of patients with homologous recombination repair (HRR) and breast cancer (BRCA) 1/2 mutations had the best outcomes. Olaparib + abiraterone, talazoparib + enzalutamide, and niraparib + abiraterone are approved combinations, expanding treatment options in mCRPC.

Conclusion

PARPi + NHA represent a significant advance in mCRPC therapy. Molecular genetic testing for HRR mutations, especially BRCA 1/2, is crucial for treatment planning.