Despite advances in prostate cancer treatment, metastatic prostate cancer remains a fatal disease. Over the last few years, huge work has gone into discovering therapies directed specifically at some targets in these cells. There are, however, few available options.
One such option is PARP inhibitors. It has recently been discovered that numerous patients with metastatic prostate cancer have mutations in the different mechanisms that repair the DNA. This causes the cells to accumulate more mutations, which they cannot repair and they increasingly become more aggressive. These patients can be treated with specific drugs called PARP inhibitors, which effectively kill these tumour cells. However, they do not work equally well for all patients. In fact, over time a patient’s sensitivity to these treatments can change. Furthermore, other therapies can make PARP inhibitors work more or less effectively in patients. Understanding how and why this occurs can save the lives of many patients.
Dr Mateo is attempting to understand precisely this through an ambitious study in which thousands of samples of prostate tumours at different stages will be studied at a molecular level (not only genetic, but also using other approaches). How and when changes that make prostate tumours vulnerable to PARP inhibitors happen will be examined in detail. This will lead to the development of a method applicable in daily clinical practice, which will identify which patients will improve with PARP inhibitors and, ultimately, see a significant improvement in their quality of life.