Lack of synergy between AR-targeted therapies and PARP inhibitors in homologous recombination–proficient prostate cancer

N Nicole A. Traphagen (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) E Esmé Wheeler (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) R Rong Li T Tara Akhshi (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) R Ramya Ravindranathan (Department of Radiation Oncology, Dana-Farber Cancer Institute and Harvard Medical School) C Christian Alfieri (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) F Feng Lu (Department of Medical Oncology, Dana-Farber Cancer Institute) B Buraq Ahmed (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) A Alok K. Tewari (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) S Steven P. Balk (Department of Medicine, Beth Israel Deaconess Medical Center) P Peter S. Nelson (Division of Hematology and Oncology, University of Washington, Fred Hutchinson Cancer Center) E Eva Corey (Department of Urology, University of Washington) H Henry Long (Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School) A Alan D. D’Andrea (Division of Radiation and Genome Stability, Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School) X Xintao Qiu (Department of Medical Oncology, Dana-Farber Cancer Institute) M Myles Brown (Department of Medical Oncology, Dana-Farber Cancer Institute)

Abstract

Recent clinical trials have explored the combination of androgen receptor (AR) pathway inhibitors and poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors as a potential treatment for castration-resistant prostate cancer. This combination treatment is based on the premise that AR directly regulates expression of DNA repair genes, leading to synergy between PARP and AR inhibition. Despite some promising preclinical evidence, this combination therapy has shown limited efficacy in patients with homologous recombination (HR)–proficient tumors. To investigate this discrepancy between preclinical and clinical results, we profiled the effects of PARP inhibition in prostate cancer models in the presence or absence of AR inhibition. Surprisingly, AR inhibition impaired response to PARP inhibitors in castration-sensitive cells and had no effect on response in castration-resistant cells. AR inhibition also did not regulate DNA repair in either the castration-resistant or castration-sensitive setting. Instead, we find that cell cycle progression is required for response to PARP inhibition in homologous recombination–proficient prostate cancer.

Article Details

Volume / Issue Vol. 123, Issue 5
Published February 03, 2026
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (16)

N

Nicole A. Traphagen

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

E

Esmé Wheeler

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

R

Rong Li

T

Tara Akhshi

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

R

Ramya Ravindranathan

Department of Radiation Oncology, Dana-Farber Cancer Institute and Harvard Medical School

C

Christian Alfieri

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

F

Feng Lu

Department of Medical Oncology, Dana-Farber Cancer Institute

B

Buraq Ahmed

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

A

Alok K. Tewari

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

S

Steven P. Balk

Department of Medicine, Beth Israel Deaconess Medical Center

P

Peter S. Nelson

Division of Hematology and Oncology, University of Washington, Fred Hutchinson Cancer Center

E

Eva Corey

Department of Urology, University of Washington

H

Henry Long

Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School

A

Alan D. D’Andrea

Division of Radiation and Genome Stability, Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School

X

Xintao Qiu

Department of Medical Oncology, Dana-Farber Cancer Institute

M

Myles Brown

Department of Medical Oncology, Dana-Farber Cancer Institute