Navigating CRPC: PARP Inhibitors, Radioligands, and Sequencing Strategies

A regional roundtable discussion, moderated by Brian Myre, MD, Brian Moran Cancer Institute, examined the evolving landscape of prostate cancer management—from localized disease and salvage strategies to metastatic settings and future innovations in precision therapy. Dr. Myre was joined by other practitioners in the greater Chicago area, including Andrew Wiele, DO, Endeavor Health Cancer Institute; Ranko Miocinovic, MD, Brian Moran Cancer Institute; Amit R. Patel, MD, Brian Moran Cancer Institute; Ashley Ross, MD, PhD, Northwestern Feinberg School of Medicine; and Alan Wan, DO, Brian Moran Cancer Center. In the fifth segment, they discuss treatment strategies for patients with BRCA2 or other HR mutations, weighing single-agent versus combination PARP inhibitors, and the sequencing of therapies in the castrate-resistant space. They also explore the practical use of radioligand therapies, including PSMA-targeted agents and radium, covering patient selection, monitoring strategies, and how many cycles to administer.