Recent Advances and Future Directions in the Management of Metastatic Castration-Resistant Prostate Cancer using Androgen Receptor Signaling Inhibitors and Poly-adipose Polymerase Inhibitors: a Literature Review

Abstract

Prostate cancer is still the most common cancer in men and the second leading cancer-related cause of death in men worldwide. There are several types of prostate cancer. One of which is the metastatic progression of castration-resistant prostate cancer (mCRPC). According to current studies, the mechanism of resistance can be categorized into classical androgen receptor (AR) pathway overexpression, abnormal AR pathway activation, and non-AR pathway. These mechanisms develop overtime to further induce treatment resistance in mCRPC. Development of novel therapeutic treatments is necessary to tackle this issue. Recent studies have been conducted on the combination therapy of androgen receptor signaling inhibitors (ARPi) and poly (ADP-ribose) polymerase inhibitors (PARPi) in treating mCRPC shows a nuanced perspective regarding its efficacy compared to monotherapy. Studies shows the combination therapy has significantly prolong radiographic progression-free survival (rPFS) compared to monotherapy in certain genetic groups. Further research is necessary to fully understand their role in the broader mCRPC treatment landscape.