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Genomically Targeted Treatment Slows Advanced Prostate Cancer

Men receiving olaparib versus standard treatment experience delayed disease progression

doctor and patient

MONDAY, May 4, 2020 (HealthDay News) -- Genomic targeted prostate cancer treatment shows a survival benefit in patients with metastatic castration-resistant prostate cancer, according to a study published online April 28 in the New England Journal of Medicine.

Johann de Bono, M.B.Ch.B., Ph.D., from the Royal Marsden Hospital in London, and colleagues conducted a randomized, open-label, phase 3 trial to study the poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor olaparib in men with metastatic castration-resistant prostate cancer who had disease progression while receiving a new hormonal agent (e.g., enzalutamide or abiraterone).

Among 245 men with at least one genetic alteration in BRCA1, BRCA2, or ATM (cohort A), the researchers found that imaging-based progression-free survival was significantly longer in the olaparib group versus the control group (median, 7.4 versus 3.6 months; hazard ratio for progression or death, 0.34). Furthermore, there was a significant benefit for the confirmed objective response rate and the time to pain progression. In cohort A, the median overall survival was 18.5 months in the olaparib group and 15.1 months in the control group, with 81 percent of the patients in the control group who had progression crossing over to receive olaparib. The main adverse events associated with olaparib were anemia and nausea.

"In men with metastatic castration-resistant prostate cancer who had disease progression while receiving enzalutamide or abiraterone and who had alterations in genes with a role in homologous recombination repair, olaparib was associated with longer progression-free survival and better measures of response and patient-reported end points than either enzalutamide or abiraterone," the authors write.

The study was funded by AstraZeneca and Merck Sharp & Dohme; AstraZeneca manufactures olaparib.

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