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ASCO GU 2023: Rucaparib Extends Survival for Metastatic, Castration-Resistant Prostate Cancer
Findings seen compared with docetaxel or second-generation androgen-receptor pathway inhibitor
THURSDAY, Feb. 23, 2023 (HealthDay News) – Rucaparib is associated with significantly longer progression-free survival (PFS) than control medication among patients with metastatic, castration-resistant prostate cancer with a BRCA alteration, according to a study published online Feb. 16 in the New England Journal of Medicine to coincide with the American Society of Clinical Oncology Genitourinary Cancers Symposium, held from Feb. 16 to 18 in San Francisco.
“This trial and others indicate that not only should patients with BRCA alterations be treated with a poly(ADP-ribose) polymerase inhibitor, but they also likely should be treated as soon as possible,” Karim Fizazi, M.D., Ph.D., from Paris-Saclay University in France, told Elsevier’s PracticeUpdate.
Fizazi and colleagues conducted a phase 3 trial in which patients with metastatic, castration-resistant prostate cancer with a BRCA1, BRCA2, or ATM alteration and who had disease progression after treatment with a second-generation androgen-receptor pathway inhibitor (ARPI) were randomly assigned to receive oral rucaparib (600 mg twice daily; 270 patients) or a physician’s choice control (docetaxel or a second-generation ARPI [abiraterone acetate or enzalutamide]; 135 patients).
The researchers found that at 62 months, the duration of imaging-based PFS was significantly longer in the rucaparib-treated group versus the control group, both in the BRCA alteration subgroup (median, 11.2 versus 6.4 months; hazard ratio [HR], 0.50) and in the intention-to-treat group (median, 10.2 versus 6.4 months; HR, 0.61; P < 0.001 for both). In the ATM alteration subgroup, median duration of imaging-based PFS tended to be longer (8.1 months for rucaparib versus 6.8 months for control; HR, 0.95; 95 percent confidence interval, 0.59 to 1.52).
“One of the most notable findings of the study is the fact that rucaparib beat a docetaxel-containing control arm, making it the first drug to ever prove superior to docetaxel for metastatic-resistant prostate cancer,” coauthor Alan H. Bryce, M.D., from the Mayo Clinic in Scottsdale, Arizona, told Elsevier’s PracticeUpdate.
Clovis Oncology funded the study.
