Shahrin Ahmed: Advanced prostate cancer with genetic mutations can be improved by combination therapy
Shahrin Ahmed, Medical specialist in oncology at the Canadian Cancer Society, shared a post on X:
“Advanced prostate cancer with genetic mutations can be improved by combination therapy.
Patients with metastatic castration-resistant prostate cancer experienced an improvement in progression-free survival with a combination therapy. Therapy alone or sequential therapy is used to compare these distinct genetic mutations.
We were able to determine the effectiveness of abiraterone/prednisone, olaparib, and a mix of these treatments through the trial design. Men with mCRPC who have specific genetic alterations in their tumors are eligible for first-line treatment.
Combined with abiraterone/prednisone and olaparib, the response rates were higher, as shown in the results. The progression of disease takes longer than with either agent alone or sequentially.
When prostate cancer spreads to different parts of the body and stops responding to hormone treatment, it becomes metastatic castration-resistant prostate cancer (mCRPC), which can then spread to other areas of the body.
Homologous Recombination-Repair Mutations (HRRms) are distinct genetic alterations that are present in nearly one-third of mCRPC patients as well as in some individuals without mCRPC. This subgroup of patients is particularly highlighting the need for targeted therapies in the BRCA1/2 and ATM genes.
Oliaparib acts as a PARP inhibitor that stops the poly ADP ribose polymerase enzyme, which is a key component of DNA repair. The FDA approved it in 2020 to treat mCRPC in patients with HRRms who experienced cancer progression after previous hormonal therapy.
Treatment was given to all patients until their cancer advanced, with the option for patients on either single-agent portion of the study to switch to the other if their cancer advanced.
The combination of abiraterone, prednisone, and olaparib was shown to be more effective in improving progression-free survival compared to either therapy alone or sequentially.
Compared to single-agents or sequentially following progression, the median time to disease progression was more than doubled in the combination therapy.
The reason why prostate cancer cells become resistant to current medications requires more research. Researchers can develop more effective treatments, such as combination therapies, that improve response and disease control. To gain a better understanding of how these therapies may have a potential impact on earlier disease stages.”
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