Efficacy

Efficacy of Lynparza (Olaparib) in Prostate Cancer

Lynparza (olaparib) is a targeted therapy known as a PARP inhibitor. It has shown efficacy in the treatment of metastatic castration-resistant prostate cancer (mCRPC) with specific genetic mutations. In clinical trials, Lynparza has demonstrated significant activity in patients whose tumors have defects in DNA repair genes, such as BRCA1, BRCA2, or ATM. The drug works by exploiting the DNA repair pathway deficiencies in cancer cells, leading to cell death. In a pivotal phase III trial, known as PROfound, Lynparza significantly improved radiographic progression-free survival (rPFS) compared to new hormonal agent therapies in men with mCRPC who have these mutations and whose disease had progressed on prior treatment.

It is important to note that Lynparza is specifically indicated for patients with HRR gene-mutated mCRPC who have progressed following prior treatment with enzalutamide or abiraterone. The PROfound trial demonstrated that patients with at least one alteration in BRCA1, BRCA2, or ATM treated with olaparib showed a median rPFS of 7.4 months compared to 3.6 months with hormonal agents, which was a statistically significant improvement. Additionally, a subset analysis indicated a trend toward improved overall survival with Lynparza in these patients, although this outcome did not reach statistical significance in all patient cohorts.

Efficacy of Erleada (Apalutamide) in Prostate Cancer

Erleada (apalutamide) is an androgen receptor inhibitor that has been approved for the treatment of non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic castration-sensitive prostate cancer (mCSPC). The drug works by blocking the effect of androgens, which can promote the growth of prostate cancer cells. In the pivotal SPARTAN trial, which led to its approval for nmCRPC, apalutamide significantly improved metastasis-free survival (MFS) compared to placebo. The median MFS was 40.5 months for patients taking apalutamide versus 16.2 months for those on placebo, marking a substantial improvement in delaying disease progression.

For patients with mCSPC, the TITAN trial demonstrated that adding apalutamide to androgen deprivation therapy (ADT) significantly improved both radiographic progression-free survival and overall survival compared to placebo plus ADT. The dual primary endpoints were met, with a 33% reduction in the risk of death and a 52% reduction in the risk of radiographic progression or death with apalutamide treatment. These results establish Erleada as an effective option for extending survival and delaying disease progression in patients with advanced prostate cancer.