Prostate cancer (PC) is one of the most common malignant neoplasms both in the world and in Russia. This disease is one of the leading causes of cancer mortality in the male population. Currently, the pathogenesis of PC has been studied in detail, which makes successful radical treatment possible in most cases, but on average, 10–20% of patients gradually develop castration-resistant (CRPC) and metastatic (mPC) prostate cancer. The mechanisms that contribute to the development of prostate cancer in the absence of androgen stimulation are currently being actively studied. A personalized approach in oncology makes it possible to timely identify specific mutations and correctly select the most effective therapy. This article attempts to summarize the current evidence on one such treatment approach, the use of PARP inhibitors. Drugs in this group are most effective against cancer with BRCA1/2 gene mutations and are also successfully used in ovarian, breast and pancreatic cancer. The presented clinical case of patient R., 67 years old with adenocarcinoma (Gleason 7), in whom BRCA2 mutations were identified based on the results of a genetic study, illustrates the successful use of olaparib in mCRPC. The use of personalized tests has made it possible to formulate clear indications for the use of PARP inhibitors in the treatment of mCRPC. Research in new areas of use of PARP inhibitors is currently relevant.

Keywords: metastatic castration-resistant cancer, olaparib, PARP inhibitors, prostate cancer, personalized medicine