Rucaparib – drug evaluation: a PARP inhibitor for the treatment of BRCA-mutated metastatic castration-resistant prostate cancer

) is the first FDA-approved poly (ADP-ribose) polymerase (PARP) inhibitor for men with BRCA mutation-associated metastatic castration-resistant prostate cancer (mCRPC). Rucaparib's efficacy in patients with mCRPC associated with DNA damage repair (DDR) deficiency was demonstrated in the TRITON2 and TRITON3 trials. In TRITON2, rucaparib demonstrated meaningful antitumor activity in men with measurable BRCA-mutated disease, with objective responses observed across both germline and somatic mutations. In TRITON3, rucaparib improved radiographic progression-free survival (rPFS) over physician's choice of therapy (docetaxel or a second-generation androgen-receptor pathway inhibitor [ARPI]). Rucaparib is the only drug to have shown improved rPFS versus docetaxel in mCRPC. Rucaparib demonstrated a consistent and manageable safety profile similar to other PARP inhibitors, with the most common adverse events being fatigue/asthenia, musculoskeletal pain, nausea, and anemia/decreased hemoglobin. Men with mCRPC face prolonged and complex treatments, during which maintaining quality of life, minimizing toxicity, and preserving functional status are major priorities. For patients with BRCA mutations, rucaparib offers a targeted oral alternative to chemotherapy that can delay mCRPC progression while reducing many of the logistical, physical, and clinical burdens commonly associated with chemotherapy. Its oral administration and flexible dosing enable an individualized approach that reduces treatment interruptions and maximizes clinical benefits.