PROfound: Efficacy of olaparib (ola) by prior taxane use in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) gene alterations.

Authors

null

Johann S. De Bono

The Institute of Cancer Research and Royal Marsden, London, United Kingdom

Johann S. De Bono , Karim Fizazi , Fred Saad , Neal D. Shore , Guilhem Roubaud , Mustafa Ozguroglu , Nicolas Penel , Nobuaki Matsubara , Niven Mehra , Giuseppe Procopio , Michael Paul Kolinsky , Kazuo Nishimura , Susan Feyerabend , Jae Young Joung , Nicholas J. Vogelzang , Michael Anthony Carducci , Jinyu Kang , Christian Heinrich Poehlein , Wenting Wu , Maha H. A. Hussain

Organizations

The Institute of Cancer Research and Royal Marsden, London, United Kingdom, Institut Gustave Roussy, University of Paris Sud, Villejuif, France, Centre Hospitalier de l’Université de Montréal/CRCHUM, Montreal, QC, Canada, Carolina Urologic Research Center, Myrtle Beach, SC, Institut Bergonié, Bordeaux, France, Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey, Department of Medical Oncology, Centre Oscar Lambret, Lille, France, Division of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan, Radboud University Medical Center, Nijmegen, Netherlands, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, Department of Medical Oncology, University of Alberta Cross Cancer Institute, Edmonton, AB, Canada, Department of Urology, Osaka International Cancer Institute, Osaka, Japan, Studienpraxis Urologie, Nürtingen, Germany, Center for Prostate Cancer, National Cancer Center, Goyang, South Korea, Comprehensive Cancer Centers of Nevada, Las Vegas, NV, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, AstraZeneca, Gaithersburg, MD, Merck & Co., Inc., Kenilworth, NJ, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL

Research Funding

Pharmaceutical/Biotech Company
AstraZeneca and Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc

Background: Optimal sequencing of therapies for mCRPC is not established. In the Phase III PROfound study (NCT02987543), ola significantly prolonged radiographic progression-free survival (rPFS) vs physician’s choice of new hormonal agent (pcNHA) in pts with mCRPC and an alteration in genes with a direct or indirect role in HRR. We report exploratory subgroup analyses by prior taxane (yes vs no). Methods: Men with mCRPC that had progressed on prior NHA were randomized to ola (tablets; 300 mg bid) or pcNHA (enzalutamide or abiraterone). Pts had alterations in BRCA1, BRCA2 or ATM (Cohort A) or ≥1 of 12 other prespecified genes with a direct or indirect role in HRR (Cohort B). Stratification factors were prior taxane use and measurable disease. rPFS was assessed by blinded independent central review with RECIST v1.1 + PCWG3. Results: Subgroup analyses of rPFS and overall survival (OS) favored ola vs pcNHA irrespective of prior taxane in Cohort A, Cohorts A+B and pts with a BRCA1 and/or BRCA2 or CDK12 alteration (Table). In the ATM subgroup hazard ratio (HR) point estimates for rPFS and OS were lower in pts who had received prior taxane vs pts who had not, but 95% CIs overlapped and pt numbers were small so data should be interpreted with caution. Conclusions: The benefit of ola over pcNHA in pts with mCRPC and HRR gene alterations was generally independent of prior taxane status in the overall study population.Clinical trial information: NCT02987543

N
Median rPFS, m
Median OS,
m
TaxaneOlapcNHAOlapcNHAHR (95% CI)OlapcNHAHR (95% CI)
Cohort AY106527.41.90.28 (0.19, 0.41)17.311.70.57 (0.36, 0.93)
N56317.44.10.55 (0.32, 0.97)20.719.10.84 (0.38, 2.01)
Cohort A+BY170845.82.60.39 (0.29, 0.53)15.811.40.61 (0.43, 0.88)
N86475.84.80.77 (0.50, 1.22)20.719.10.87 (0.45, 1.72)
BRCA1 and/or BRCA2Y72359.01.90.19 (0.12, 0.32)18.510.70.62 (0.35, 1.12)
N302313.63.70.17 (0.08, 0.36)NR19.10.45 (0.15, 1.25)
ATMY35155.73.60.55 (0.28-1.15)17.212.50.54 (0.22, 1.40)
N2795.35.72.41 (0.97-7.30)NRNR2.94 (0.55, 54.29)
CDK12Y46204.32.10.65 (0.36, 1.26)11.411.50.71 (0.36, 1.48)
N1585.54.20.87 (0.29, 3.18)21.3NR0.43 (0.09, 2.20)

m, months; N, no; NR, not reached; Y, yes

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Abstract Details

Meeting

2020 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer - Advanced,Prostate Cancer - Localized

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT02987543

Citation

J Clin Oncol 38, 2020 (suppl 6; abstr 134)

Abstract #

134

Poster Bd #

F14

Abstract Disclosures