Niraparib With Abiraterone Boosts Survival in BRCA-Mutated Prostate Cancer

Kim N. Chi, MD, FRCPC, medical oncologist, vice president, chief medical officer, British Columbia Cancer, professor, Division of Medical Oncology, University of British Columbia, discusses results from the MAGNITUDE trial (NCT03748641), including those on survival and patient-reported outcomes in patients with BRCA-positive metastatic castration-resistant prostate cancer (mCRPC) receiving niraparib (Zejula) plus abiraterone acetate and prednisone.

Previously in August 2023, the FDA approved the combination of niraparib and abiraterone acetate tablets (Akeega) with prednisone for the treatment of adult patients with deleterious or suspected deleterious BRCA-positive mCRPC, as detected by an FDA-approved test.

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0:09 | In this trial, we selected patients and what was reported on [was] patients with BRCA alterations or BRCA mutations. BRCA is a gene that when mutated, it can result in defects and homologous recombination repair. These kinds of cancers are very sensitive to PARP inhibitors, such as niraparib. In this study, we evaluated the combination of abiraterone plus niraparib vs abiraterone alone. We did see improvements in radiographic progression-free survival, as well as in subgroup analysis, improvements in overall survival.

0:43 | In the study, we also looked at patient-reported outcomes, primarily around quality of life, as well as pain, and specifically looked at questions around [adverse] effects. What we found is that overall quality of life was maintained. Despite the improvements and the more intensified therapy with the PARP inhibitor, quality of life was maintained, which is important. So the extra [adverse] effects from treatment were not impacting their quality of life. We did see a trend to delayed pain progression, which is also important as a symptom, and then thirdly, what we saw is that the [adverse] effect bother was pretty minimal. Altogether, we see patient benefits in terms of radiographic progression-free survival trends to overall survival trends to pain progression improvements. However, it was not at a detriment of quality of life or [adverse] effect bother.