Results from the Phase 3 MAGNITUDE study, presented at the ESMO 2023 Congress in Madrid, reveal promising outcomes for patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations.
A pre-planned multivariate analysis showed that combining niraparib, a selective poly (ADP-ribose) polymerase (PARP) inhibitor, with abiraterone acetate and prednisone significantly improved overall survival (OS), time to symptomatic progression (TSP), and showed a favorable trend in time to cytotoxic chemotherapy (TCC) when compared to the placebo group. These results indicate that this combination therapy could be a groundbreaking first-line treatment for this group of patients.
The analysis included 225 BRCA-positive mCRPC patients, with 113 receiving niraparib plus abiraterone acetate and prednisone (AAP) and 112 on placebo plus AAP. After a median follow-up of 35.9 months, the MVA showed significant benefits in OS for the niraparib plus AAP group (HR=0.66), along with improvements in TSP (HR 0.56) and a favorable trend in TCC (HR 0.60).
Furthermore, patient-reported outcomes revealed a trend toward delayed time to worst pain progression and pain interference progression in the niraparib and AAP groups. The analysis also indicated no new safety concerns. Adverse events were consistent with the known safety profile of niraparib, including anemia and thrombocytopenia.
These results suggest that this targeted therapy could significantly improve the prognosis and quality of life for patients with BRCA-altered mCRPC, highlighting the importance of personalized treatment for patients with genetically defined cancers.
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