Keeping patients on PARP inhibitors long enough to see real benefit often comes down to proactive side effect management. In this episode of BackTable Urology, Dr. Neeraj Agarwal and Dr. Arun Azad join host Dr. Alan Tan to discuss practical, evidence-based strategies for managing hematologic and GI toxicities in advanced prostate cancer patients receiving PARP inhibitors.

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This podcast is supported by an educational grant from Pfizer.

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Timestamps

00:00 - Introduction
06:17 - Managing Anemia
11:12 - Side Effect Profiles
19:33 - Transfusions vs ESAs
26:43 - Docetaxel vs PARP Inhibitors
30:27 - Side Effect Management Pearls
40:18 - Team Based Monitoring
52:27 - Tissue Versus Liquid
01:01:24 - Genetic Counseling Workflow
01:07:07 - Trial Equity and Access

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More about this episode

The doctors discuss the importance of close anemia monitoring during the critical first 3 to 4 months of therapy, maintaining dose intensity, proactive antiemetic use, and the role of exercise and resistance training in combating fatigue. The conversation also covers differences in toxicity profiles between PARP agents, the value of multidisciplinary care teams, molecular advances in molecular and germline testing, and the evolving landscape of emerging therapies in prostate care.

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Resources

Talazoparib plus enzalutamide in men with metastatic castration-resistant prostate cancer: final overall survival results from the randomised, placebo-controlled, phase 3 TALAPRO-2 trial
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(25)00684-1/abstract

BRCAAway: A randomized phase 2 trial of abiraterone, olaparib, or abiraterone + olaparib in patients with metastatic castration-resistant prostate cancer (mCRPC) bearing homologous recombination-repair mutations (HRRm).
https://ascopubs.org/doi/10.1200/JCO.2024.42.4_suppl.19

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