Adding olaparib to abiraterone does not clinically worsen health-related quality of life (HRQoL) compared with abiraterone alone in patients with metastatic castration-resistant prostate cancer (mCRPC), according to findings from the phase 3 PROpel trial were presented at the American Society of Clinical Oncology’s 2023 annual meeting in Chicago, Illinois.

The original PROpel trial showed that the combination of the PARP inhibitor and abiraterone significantly prolonged radiographic progression-free survival by 34% compared with abiraterone plus placebo. At baseline, most patients had no pain or mild pain (74.6%) and were not taking opiates (87.6%). A homologous recombination repair gene mutation was not required.

Andrew J. Armstrong, MD, MSc, of the Duke Cancer Institute Center for Prostate and Urologic Cancer in Durham, North Carolina, and colleagues found no clinically meaningful effect of olaparib (300 mg twice daily) plus abiraterone (1000 mg) on HRQoL as assessed by the Functional Assessment of Cancer Therapy—Prostate Cancer total and subscale scores and Brief Pain Inventory-Short Form scores.

Early data suggested time to pain progression, time to first symptomatic skeletal-related event, or time to opiate use does not differ significantly between treatment arms.

Time to chemotherapy was significantly longer for olaparib plus abiraterone versus abiraterone with placebo — 32.0 vs 22.4 months — corresponding to a significant 28% lower likelihood of initiating chemotherapy in the olaparib arm. Among patients with BRCA mutations (11.8% of combination group and 9.6% of abiraterone alone group), time to chemotherapy was not reached in the olaparib arm vs 14.9 months in the placebo arm.

Adding Olaparib to Abiraterone Does Not Worsen HRQoL in mCRPC

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