Niraparib is in clinical development for the treatment of metastatic castrate-resistant prostate cancer (mCRPC) with DNA-repair anomalies. Prostate cancer is the most common type of cancer in men in the UK. The cancer is called advanced (metastatic) prostate cancer when the cancer cells have spread to other parts of the body like bones, lymph nodes outside the pelvis or rarely to the liver or lungs. It is not possible to cure metastatic prostate cancer but is possible to keep it under control. Prostate cancers that continue to grow despite hormonal therapies are called “castration-resistant” prostate cancer. In some mCRPC, mutations in several genes involved in DNA damage repair have been reported and treatments that target these DNA anomalies are being developed.
Niraparib is a medicinal product taken orally. It works by blocking a protein called poly (adenosine diphosphate-ribose) polymerase (PARP). It blocks the action of PARP-1 and PARP-2 enzymes that help in repairing damaged DNA in cells when they divide to make new cells. By blocking PARP enzymes, the damaged DNA in cancer cells cannot be repaired, and the cells die. If licensed, niraparib will offer an additional treatment option for men with mCRPC with DNA-repair anomalies.
Pembrolizumab is an immunomodulatory medicinal product, meaning that it helps the immune system to recognise and attack cancer cells. It is administered by intravenous infusion and is currently licensed in the UK for melanoma, non-small cell lung cancer and urothelial cancer – amongst others. If licensed, pembrolizumab, in addition to chemotherapy, would offer an alternative treatment for those with advanced, recurrent or metastatic cervical cancer.