Patients with metastatic castration-resistant prostate cancer benefit from niraparib plus abiraterone acetate and prednisone

A recent study suggests that patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations showed clinically relevant outcomes when treated with niraparib plus abiraterone acetate and prednisone (AAP). This study’s results were published in the Annals of Oncology.

The phase 3, MAGNITUDE trial included 212 HRR+ patients with/without BRCA1/2 alterations. They were randomized in a 1:1 ratio to receive 200mg of niraparib orally plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At the second prespecified interim analysis (IA2), the secondary endpoints assessed were time to symptomatic progression, time to initiation of cytotoxic chemotherapy and overall survival (OS).

It was found that at IA2 with 24.8 months of median follow-up, niraparib plus AAP showed significantly prolonged radiographic progression-free survival (rPFS) (19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78] consistent with the first prespecified interim analysis. Similarly, in the total HRR+ population, rPFS was also prolonged. In the niraparib plus AAP group, time to symptomatic progression and time to initiation of cytotoxic chemotherapy showed improvements. Even the analysis of OS with niraparib plus AAP in the BRCA1/2 subgroup demonstrated a lower hazard ratio.

From the above results, it is clear that niraparib plus AAP in patients with BRCA1/2-altered mCRPC, may demonstrate an improved rPFS and other clinically relevant outcomes.