Ask AI
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

Pretest

Progress
1 2
Course Completed
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?