Despite the fact that substantial survival improvements were achieved over the last two decades, prostate cancer remains lethal at the metastatic castration-resistant stage (mCRPC) and new therapeutic approaches are needed. The genomic landscape of metastatic prostate cancer reveals that up to 20% of patients harbour somatic mutations in genes involved in DNA damage response pathways, forming the rationale to assess PARP inhibition as a therapeutic modality in this setting. Several clinical trials have demonstrated the potential of PARP inhibition in mCRPC harbouring homologous recombination repair (HRR)-related gene mutations. Recently, these efforts culminated in the EMA approval of olaparib for the treatment of adult patients with mCRPC harbouring a BRCA1/2-mutation who progressed following prior therapy, including a novel hormonal agent (i.e. abiraterone acetate or enzalutamide).
