Dr. Saad on the Efficacy of First-Line Olaparib Plus Abiraterone in mCRPC

Fred Saad, MD, FRCS, principal scientist, University of Montreal Hospital Center (CHUM) Research Center (CRCHUM), head, Urology, CHUM, director, prostate cancer research, Montreal Cancer Institute/CRCHUM, full professor, Department of Surgery, Raymond Garneau Chair in Prostate Cancer, University of Montreal, discusses the efficacy of olaparib (Lynparza) plus abiraterone acetate (Zytiga) as first-line treatment in metastatic castration-resistant prostate cancer (mCRPC).

The phase 3 PROpel trial (NCT03732820) investigated olaparib plus abiraterone vs placebo plus abiraterone in patients with mCRPC following the failure of primary androgen deprivation therapy. Patients were enrolled independent of homologous recombination repair (HRR) mutational status. The primary end point of the trial was investigator-assessed radiographic progression-free survival (rPFS) in all patient subsets, Saad says.

Results indicated a 34% reduction in the risk of disease progression or death with the addition of olaparib, which correlated with an 8-month improvement in rPFS, according to Saad.

Although overall survival (OS) data remain immature, there is a trend toward improved OS with olaparib, Saad notes. Furthermore, early data point to a significant improvement in both the time to subsequent therapy and second PFS or death, Saad continues. Across various subgroups, patients benefited from olaparib regardless of prior chemotherapy in the hormone-sensitive setting; age; site of metastases; and, most importantly, HRR mutational status, Saad concludes.