Olaparib ± abiraterone (PARP-1/2 inhibitor) slashes rPFS risk by ≈ 75% in BRCA-mut mCRPC

Phase 3 data compiled in a new review show that olaparib monotherapy in PROfound’s Cohort A (BRCA1/2 ± ATM; n = 162 vs 83) cut radiographic PFS by 78% vs physician-choice ARPI (HR 0.22) and improved OS (HR 0.63); in first-line PROpel, adding olaparib to abiraterone in the BRCA-mut subgroup (47 vs 38 of 85 pts) reduced progression/death by 76% (HR 0.24) and death by 70% (HR 0.30), with rPFS not reached vs 8 mo. Anemia dominated safety (any-grade 41–46%, grade ≥3 15–21%) and drove ≤18% discontinuations, but other high-grade toxicities were modest.