Should We "PROpel" Olaparib Forward for Metastatic Castration-Resistant Prostate Cancer?

VanderWeele, David J; Hussain, Maha · NEJM Evid · 2022

editorial · Level V

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Abstract

Poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors have shown therapeutic success for patients with metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair (HRR) deficiency.<sup>1,2</sup> Preclinical data suggest that PARP inhibitors may have efficacy in a wider population if combined with androgen receptor inhibition.<sup>3,4</sup> One phase 2 trial for late-stage mCRPC supports this notion, finding that olaparib added to abiraterone/prednisone improved radiographic progression-free survival (PFS) versus abiraterone/prednisone alone in a population that was not biomarker preselected.<sup>5</sup> However, another trial with abiraterone and veliparib did not show benefit.<sup>6</sup>.

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