Alan Bryce, MD PARP inhibition with olaparib (Lynparza) improved radiographic progression-free survival (rPFS) in heavily pretreated patients with metastatic castration-resistant prostate cancer (mCRPC) who had alterations in homologous recombination repair (HRR) genes, according to findings from the phase III PROfound trial presented at the 2019 ESMO Congress. This was the first positive randomized phase III trial reported evaluating a PARP inhibitor in men with mCRPC. The PROfound trial enrolled patients to 2 cohorts. In cohort A, 245 patients with BRCA1/2 or ATM alterations, markers of HRR, were randomized 2:1 to receive either olaparib (n = 162) or physician’s choice of abiraterone acetate (Zytiga) with prednisone or enzalutamide (Xtandi) (n = 83). In cohort B, 142 patients with alterations in the BARD1, BRIP1, CDK12, CHEK1/2, FANCL, PALB2, PPP2R2A, RAD51B/C/D , or RAD54L , all of which are associated with HRR indirectly, were also randomized 2:...
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