PARPi in Advanced PC

CME

PARP Inhibitors in Advanced Prostate Cancer: Overcoming Global Challenges in Testing and Treatment

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: June 03, 2024

Expiration: June 02, 2025

Karim Fizazi
Karim Fizazi, MD, PhD
Joaquin Mateo
Joaquin Mateo, MD, PhD

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

How often do you ensure that patients with metastatic prostate cancer are offered molecular testing for DNA damage repair alterations?

2.

Patient Case: mCRPC With BRCA2 Mutation



  • 66-yr-old man presents with mild fatigue

  • Medical history: osteoarthritis and well-controlled DM

    • FH of breast cancer in sister, aged 56 yr



  • Biopsy: 9/12 cores; adenocarcinoma Gleason 4+4, cribriform pattern identified

  • Staging: T3 by DRE and mpMRI, N1 M1a, low-volume mHSPC

  • Imaging: bone and CT scan

    • No bone metastases

    • Multiple pelvic and retroperitoneal lymph nodes between 1-3 cm



  • PSA: 25

  • Managed with ADT alone; declined ARPI at the time

  • PSA at 12 mo: 0.2 (nadir)

  • PSA at 18 mo: 1.2

  • PSA at 24 mo: 14.4

    • Slight discomfort in lumbar spine

    • Bone and CT scan: new lesions and progression of lymph nodes

    • Hgb: 11 g/dL



  • Genetic testing identified a pathogenic germline BRCA2 mutation

Which of the following would you recommend for this patient?

3.

Patient Case Continued



  • Our previous patient with newly diagnosed mCRPC and a germline BRCA2 mutation started olaparib + abiraterone/prednisone 4 wk ago

  • He now reports fatigue, dizziness with standing, shortness of breath, and headache

  • He is diagnosed with grade 3 anemia


In addition to transfusing packed red blood cells, which of the following would you recommend for managing this patient’s grade 3 anemia?