Prostate cancer is the most common in men, and it is one of the main causes of death in them. Although in its early stages it is relatively manageable, unfortunately it is all too common to go undetected until options are much more limited.
Inhibitor of key enzymes in cancer growth
As detailed in the American Cancer Societyone of the possibilities before the advanced stage prostate cancer that is resistant to castration and chemotherapy with a taxane (drugs such as docetaxel or carbazitaxel) and that has not responded to antiandrogen treatment is rucaparib.
This drug, which is also indicated for the treatment of ovarian cancer, fallopian tube cancer, and primary peritoneal cancer, is a targeted therapy (the basis of precision medicine; this term refers to a type of cancer treatment that acts on the changes that drive the growth and reproduction of cancer cells). More specifically, it is a inhibitor PARP (poly(ADP)-ribose polymerase). This means that it neutralizes the action of PARP enzymes, some products of the organism.
And it is that this class of enzymes plays a very important role in the progression of certain types of cancer. Under normal circumstances, its function is to help repair genetic damage within the nucleus of cells (such as precisely those that could give rise to cancer). However, certain tumors have mutations specifically in the BRCA genes, also normally involved in another DNA repair process, in such a way that the altered versions obstruct the process carried out by PARPs.
Normally, prostate cancers with the characteristics described present mutations in the BRCA genes. Even so, it is usually necessary to check it, which is usually done through blood or saliva tests. On the other hand, in this class of patients, if they have not undergone an orchectomy, rucaparib is administered together with an agonist of another enzyme, LHRH. Used in this way, according to a recent study published in the scientific medium The New England Journal of Medicineincreases progression-free survival up to almost double.
References
American Cancer Society. Targeted therapy for prostate cancer. Consulted online at https://www.cancer.org/es/cancer/cancer-de-prostata/tratamiento/terapia-dirigida.html on 03/02/2023.
Karim Fizazi, Josep M. Piulats, Neil Reaume et al. Rucaparib or Physician’s Choice in Metastatic Prostate Cancer. The New England Journal of Medicine (2023). DOI: 10.1056/NEJMoa2214676