Targeted Therapy for Prostate Cancer
Targeted therapy is a type of cancer treatment that uses drugs to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells' inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but they all change the way a cancer cell grows, divides, repairs itself, or interacts with other cells.
PARP inhibitors
Rucaparib (Rubraca) and olaparib (Lynparza) are drugs known as a PARP (poly(ADP)-ribose polymerase) inhibitors. PARP enzymes are normally involved in one pathway to help repair damaged DNA inside cells. The BRCA genes (BRCA1 and BRCA2) are also normally involved in a different pathway of DNA repair, and mutations in those genes can block that pathway. By blocking the PARP pathway, these drugs make it very hard for tumor cells with an abnormal BRCA gene to repair damaged DNA, which often leads to the death of these cells. If you are not known to have a BRCA mutation, your doctor might test your blood or saliva and your tumor to be sure you have one before starting treatment with this drug.
These drugs are taken twice a day by mouth as pills.
Rucaparib (Rubraca) can be used to treat advanced castration-resistant prostate cancer that has grown after taxane chemotherapy (such as docetaxel or cabazitaxel) or anti-androgens have been tried. It can be used in men with a mutation in one of the BRCA genes. This drug is given with a LHRH agonist or to men who have had an orchiectomy.
Olaparib (Lynparza) can be used to treat advanced castration-resistant prostate cancer that has grown after the hormone therapy drugs, enzalutamide or abiraterone, have been tried. It can be used in men with a mutation in one of the BRCA genes. This drug is given with a LHRH agonist or to men who have had an orchiectomy.
Side effects of PARP inhibitors
Side effects of these drugs can include nausea, vomiting, diarrhea, fatigue, loss of appetite, low red blood cell counts (anemia), constipation, skin rash, abnormal liver blood tests, low blood platelet counts, cough and shortness of breath. Rarely, some people treated with these drugs have developed a blood cancer, such as myelodysplastic syndrome or acute myeloid leukemia. Some men taking olaparib had problems with blood clots in the lungs or legs.
More information about targeted therapy
To learn more about how targeted drugs are used to treat cancer, see Targeted Cancer Therapy.
To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Prostate Cancer. Version 2.2020. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf on June 10, 2020.
U.S. Food & Drug Administration. FDA approves olaparib for HRR gene-mutated metastatic castration-resistant prostate cancer. Published May 20, 2020. https://www.fda.gov/drugs/drug-approvals-and-databases/fda-approves-olaparib-hrr-gene-mutated-metastatic-castration-resistant-prostate-cancer. Accessed June 10, 2020.
U.S. Food & Drug Administration. FDA grants accelerated approval to rucaparib for BRCA-mutated metastatic castration-resistant prostate cancer. Published May 15, 2020. https://www.fda.gov/drugs/fda-grants-accelerated-approval-rucaparib-brca-mutated-metastatic-castration-resistant-prostate. Accessed June 10, 2020.
Last Revised: June 10, 2020
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Treating Prostate Cancer
- Observation or Active Surveillance for Prostate Cancer
- Surgery for Prostate Cancer
- Radiation Therapy for Prostate Cancer
- Cryotherapy for Prostate Cancer
- Hormone Therapy for Prostate Cancer
- Chemotherapy for Prostate Cancer
- Immunotherapy for Prostate Cancer
- Targeted Therapy for Prostate Cancer
- Treatments for Prostate Cancer Spread to Bones
- Considering Prostate Cancer Treatment Options
- Initial Treatment of Prostate Cancer, by Stage
- Following PSA Levels During and After Prostate Cancer Treatment
- Treating Prostate Cancer That Doesn’t Go Away or Comes Back After Treatment