The growing role of rucaparib in contemporary treatment of metastatic prostate cancer: a review of efficacy and guidance for side effect management.

In May 2020, the approval of rucaparib (a poly-adenosine diphosphate-ribose polymerase (PARP) inhibitor) in the USA marked the arrival of a new class of targeted, life-prolonging therapeutics for the 15-25% of metastatic castration-resistant prostate cancer patients whose tumors harbor germline or somatic BRCA1/2 gene alterations. It has now become critical for physicians to be aware of the role and nuance of management of PARP inhibitor therapies in prostate cancer.

We focus on rucaparib's pharmacology, key clinical trials that support its current indication, the competitive landscape, and our considerations for management of adverse events. We also review the ongoing clinical trials that may expand its utility in prostate cancer in our expert opinion. Finally, we discuss the opportunities that exist for further development of this class of targeted therapeutics in prostate cancer.

We believe that the time has come to develop functional assays of HRR activity or deficiency in order to better guide PARP inhibitor selection for patients with prostate cancer and beyond.

Expert review of anticancer therapy. 2022 May 20 [Epub ahead of print]

Arpit Rao, Emmanuel S Antonarakis

Hematology and Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine; One Baylor Plaza, BCM 187, Houston, TX 77030, USA., Hematology, Oncology and Transplantation, Masonic Cancer Center, University of Minnesota. 420 Delaware Street SE, MMC 480, Minneapolis, MN 55455, USA.

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