Castration-Resistant Prostate Cancer: Diagnosis and Testing Considerations with the Emerging Use of PARP Inhibitors

Course overview

This one hour, interactive, online CME/CMLE module will be developed to help pathologists and laboratory professionals understand the latest evidence regarding the anticipated future use of PARP inhibitors in the treatment of patients with castration-resistant prostate cancer using a combination of didactic lecture, digital images, and authentic, interesting patient cases and scenarios to help you apply what you have learned. Course Outline: * Current standards for the diagnosis and management of patients with advanced prostate cancer - Current diagnostic tests - Treatment progression (androgen deprivation therapy [ADT], potential resistance, chemotherapy) * The anticipated future use of poly(ADP-ribose) polymerase (PARP) inhibitors in patients with castration-resistant prostate cancer - Current use of PARP inhibitors in ovarian and breast cancer - Mechanisms of action - Current evidence and ongoing investigational efforts - Potential benefit to patients with castration-resistant prostate cancer who have DNA damage response (DDR) pathway abnormalities - Potential benefit to other patients with castration-resistant prostate cancer without DDR pathway abnormalities * Potential tests for assessing patient suitability for PARP inhibitors and response to treatment in patients with castration-resistant prostate cancer - The importance of the need for genomic sequencing and molecular testing - Potential genomic and molecular tests to identify DDR mutations - Other potential tests that may look for downstream effects - Potential testing considerations - Potential tissue requirements * Discuss evidence-based rationale for interpreting test results and reporting to other clinicians - Interpretation and reporting of molecular assays and whole exome sequencing results - Communication with other members of the multidisciplinary team - Importance of encouraging oncologists to order molecular/genomic testing for patients who are already metastatic Learning Objectives: Upon completion of this activity, you should be able to: * Discuss current standards of care and the anticipated future use of PARP inhibitors in patients with castration-resistant prostate cancer; * Explain the results of recent clinical trials and ongoing investigational efforts in the use of PARP inhibitors for the treatment of patients with castration-resistant prostate cancer; * Describe potential molecular and whole exome sequencing tests, considerations, and tissue requirements for assessing the suitability for PARP inhibitors and response to treatment in patients with castration-resistant prostate cancer; and * Discuss evidence-based rationale for interpreting test results and reporting to other clinicians. Faculty: Marc Barry, MD Associate Professor, Department of Pathology, University of Utah Director of Genitourinary Pathology, Department of Pathology, University Hospital and Huntsman Cancer Institute Salt Lake City, UT Benjamin L. Maughan, MD, PharmD Asst. Professor, Genitourinary Oncology, Department of Oncology, University of Utah and Huntsman Cancer Institute Salt Lake City, UT