Celestia Higano, MD, professor of medicine and urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses the effectiveness of PARP inhibitors for patients with metastatic prostate cancer.

Approximately one-quarter of patients with metastatic prostate cancer have DNA-damaged alterations, states Higano. PARP inhibitors are a different treatment paradigm for prostate cancer that have shown to be effective in this patient population.

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Dr. Higano on the Effectiveness of PARP Inhibitors for Prostate Cancer

Celestia Higano, MD, professor of medicine and urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses the changes being made in the field of prostate cancer. 

It is important that oncologists understand the rapid pace of changes being made in prostate cancer, states Higano. It is particularly important to remain current on what has been shown in evidence-based therapies versus what is still experimental.  

Celestia Higano, MD, professor of medicine and urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses the changes being made in the field of prostate cancer.

Dr. Higano on Changes Being Made in the Field of Prostate Cancer

Celestia Higano, MD, professor of medicine and urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses risks associated with combining radium-223 dichloride (Xofigo) for patients with prostate cancer.

Radium-223 has been studied in combination with docetaxel and it has been discovered that there can be significant myelotoxicity, explains Higano. This was unexpected since radium-223 is not associated with this type of adverse event.

It is not recommended to combine these agents but more trials are ongoing to attempt to combine radium-223 with chemotherapy, states Higano.

Dr. Higano on Combinations With Radium-223 for Prostate Cancer

Celestia Higano, MD, professor of Medicine and Urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses radium-223 for patients with prostate cancer. 

Radium-223 was shown in a phase III trial to extend survival for patients with prostate cancer, explains Higano. Unlike the other radioisotopes which are used towards the end stage, it was shown that there was a survival benefit for those who received radium-223 in addition to best supportive care.   

Celestia Higano, MD, professor of Medicine and Urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses radium-223 for patients with prostate cancer.

Dr. Higano on Radium-223 for Prostate Cancer

Celestia Higano, MD, professor of medicine and urology at the University of Washington, and a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses PARP inhibitors in prostate cancer.

In ovarian cancer, PARP inhibitors have been effective in patients with DNA repair defects. About one-quarter of patients with metastatic prostate cancer have DNA damage alterations, says Higano, suggesting that PARP inhibitors may be effective in this population.

Recently, olaparib (Lynparza) has shown promise in prostate cancer, with a high response rate in a recent small study.

Dr. Higano Discusses PARP Inhibitors in Prostate Cancer

Celestia Higano, MD, professor of Medicine and Urology, University of Washington, member of the Clinical Research Division at Fred Hutchinson Cancer Research Center, discusses results of docetaxel (Taxotere) versus hormone therapy in patients with metastatic hormone-sensitive prostate cancer. 

For the first time, docetaxel demonstrated a very large difference in median overall survival (OS) compared with hormone therapy alone. This is one of the biggest improvements in survival that has been seen in oncology, explains Higano. 

One thing to be cautious of is the impact this might have down the line. Docetaxel is usually used for metastatic castration-resistant disease, and now that it is being used for those who have metastatic hormone-sensitive disease, it might not work as well. There are some data that suggest that this happens in the castration-resistant setting, so practitioners will be cognizant of how they place docetaxel in a disease, states Higano. 

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