Previous studies have suggested that olaparib could lead to longer progression-free survival than standard therapies in men with metastatic castration-resistant prostate cancer. However, strong evidence is not yet established. This study aims to evaluate the overall survival of olaparib in patients with metastatic castration-resistant prostate cancer.

This open-label, phase 3 trial included two cohorts: cohort A had 245 patients with at least one alteration in BRCA1, BRCA2, or ATM; cohort B had 142 patients with at least one alteration in any of the other 12 genes. The patients were assigned in a 2:1 ratio to receive olaparib (n=256) or enzalutamide or abiraterone plus prednisone (control group; n=131). The primary outcome of the study was overall survival in cohort A.

The median overall survival in cohort A was 19.1 months with olaparib, compared with 14.7 months with control therapy. The median overall survival in cohort B was 14.1 months with olaparib and 11.5 months with the control therapy. The median overall survival in the entire population of cohort A and cohort B was 17.3 months and 14.0 months, respectively.

The research concluded that treatment with olaparib in men with metastatic castration-resistant prostate cancer was associated with longer overall survival.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa2022485