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Sandy Srinivas, MD


Final Overall Survival Data From PROpel on Abiraterone Plus Olaparib in Metastatic Prostate Cancer

By: Joshua D. Madera, MS
Posted: Tuesday, March 21, 2023

Combination therapy with abiraterone and olaparib prolonged overall survival by more than 7 months compared with abiraterone plus placebo in the intent-to-treat population with metastatic castration-resistant prostate cancer, based on the overall survival and safety data from the preplanned final analysis of the phase III PROpel trial. This treatment regimen seemed to have the most profound impact in patients with a BRCA mutation, explained Noel W. Clarke, MBBS, FRCS, ChM, of The Christie and Salford Royal NHS Foundation Trusts, Manchester, United Kingdom, and colleagues at the 2023 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Cancers Symposium (Abstract LBA16).

“The data reinforce the therapeutic potential of olaparib plus abiraterone and prednisone for patients with metastatic castration-resistant prostate cancer in the overall trial population and across subgroups,” commented Dr. Clarke in a press release.

A total of 796 patients with metastatic castration-resistant prostate cancer were recruited for the study. Homologous recombination repair (HRR) mutation status was assessed in all patients using circulating tumor DNA or tissue samples collected from their tumors. Patients were stratified based on HRR and BRCA mutation status and were administered combination therapy with abiraterone plus prednisone or prednisolone in conjunction with either olaparib or a placebo.

The study findings revealed a consistent trend toward significance for an overall survival benefit in patients treated with abiraterone plus olaparib (hazard ratio = 0.81). The median overall survival in this treatment group was 42.1 months. In addition, combination treatment with abiraterone and olaparib led to an improved median overall survival in all treatment groups, regardless of HRR and BRCA mutation status. Furthermore, this combination therapy was associated with various grade 3 treatment-related adverse events, including anemia (16.1%), COVID-19 infection (3.8%), hypertension (3.8%), fatigue (2.5%), and urinary tract infection (2.5%).

Disclosure: The study authors reported no conflicts of interest.

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