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Responding to unmet needs for metastatic castration-resistant prostate cancer
mCRPC in focus

Transcript: Can knowledge of treatment mechanism of action improve mCRPC management?

Last updated:4th Sep 2024
Published:4th Sep 2024

Professor Karim Fizazi

All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.

Well, I guess it's important to understand that the main and most important machinery prostate cancer cells use remain the androgen receptor or at least the androgen receptor axis. And this is even true in patients second generation AR pathway inhibitors.

So in other words most men who die from the disease still have an activated AR machinery indicating that if we are able to invent better drug to target this pathway we may actually win the party. Now, on top of that, there are other important pathways. The DNA repair pathway is an important one and it's a potential weakness of a cancer that we can use. Men with BRCA II alteration clearly benefit from PARP inhibitors. And the more we see trials, the more we have indication that PARP inhibitors should probably be used as early as we can in these men with BRCA alterations.

There are others, other molecular target for treatments. PSMA is an obvious one and it's frequently expressed. Also, it really seems that the higher the expression, the better the efficacy of PSMA and targeting agents. MSI High is another example. It predicts for immunotherapy efficacy even though immunotherapy is not formally approved at least in Europe for these men, which is a shame because it really works. MSI High patients are actually rare, just approximately 2%. Just to provide a couple of examples.

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