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PROfound: Phase 3 Study of Olaparib vs. Enzalutamide or Abiraterone for Metastatic Castration-Resistant Prostate Cancer with Homologous Recombination Repair Gene Alterations

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We previously reported that olaparib led to significantly longer imaging-based progression-free survival than the physician's choice of enzalutamide or abiraterone among men with metastatic castration-resistant prostate cancer who had qualifying alterations in homologous recombination repair genes and whose disease had progressed during previous treatment with a next-generation hormonal agent.

Multiple loss-of-function alterations in genes that are involved in DNA repair, including homologous recombination repair, are associated with response to poly(adenosine diphosphate-ribose) polymerase (PARP) inhibition in patients with prostate and other cancers.

Conference Coverage
Conference Highlights from Recent Conference Coverage
Presented by Maha H.A. Hussain, MD, FACP, FASCO
In the second Prostate Cancer session at this year’s Society of Urologic Oncology virtual annual meeting, Dr. Hussain discussed the role of PARP inhibitors, particularly Olaparib, in metastatic castration-resistant prostate cancer.
Presented by Karim Fizazi, MD, Ph.D
In an oral presentation in the New Trials Update session at the 12th European Multidisciplinary Congress on Urological Cancers (EMUC), Dr. Karim Fizazi presented a discussion of the results of PROfound Study, Study of Olaparib (Lynparza™) Versus Enzalutamide or Abiraterone Acetate in Men With Metastatic Castration-Resistant Prostate Cancer (PROfound), examining the role of olaparib among patients with metastatic castration-resistant prostate cancer (mCRPC) and DNA defect repair (DDR) mutations.
Presented by Henrik Grönberg, MD, PhD
(UroToday.com) Following the presentations from Dr. de Bono and Dr. Joaquin Mateo of the data from IPATential150 and PROfound, respectively, Dr. Henrik Grönberg provided an invited discussion of these data.  He began by laying out a number of important topics to consider: 1. study population: is this representative of patients seen in the clinic today? 2. control group: are these patients getting the best treatment available?
Presented by Joaquin Mateo, MD
In 2016, Pritchard and colleagues reported that mutations in DNA-damage repair genes, particularly homologous recombination repair genes, were relatively common among patients with advanced metastatic castration-resistant prostate cancer (mCRPC).
(UroToday.com) In the phase III PROfound study, olaparib lead to significantly longer radiographic progression-free survival compared with physician’s choice of next-generation hormonal agent (control) in patients with previously treated metastatic castration-resistant prostate cancer (mCRPC) and alterations in homologous recombination repair (HRR) genes.
(UroToday.com) In 2016, Pritchard and colleagues reported that mutations in DNA-damage repair genes, particularly homologous recombination repair genes, were relatively common among patients with advanced metastatic castration-resistant prostate cancer (mCRPC).
Presented by Fred Saad, MD, FRCS
In the Phase III PROfound study, olaparib significantly improved radiographic progression-free survival (primary endpoint) versus physician’s choice of new hormonal agent (enzalutamide or abiraterone) in patients with mCRPC and homologous recombination repair (HRR) gene alterations.
Presented by  Antoine Thiery-Vuillemin, MD, PhD
The randomized Phase 3 PROfound trial showed that olaparib significantly prolonged radiographic progression-free survival compared with physician’s choice of new hormonal agent (enzalutamide or abiraterone) in men with mCRPC and HRR gene alterations, whose disease had progressed on prior new hormonal agent.
San Francisco, California (UroToday.com) The PROfound Study is the first positive randomized Phase 3 study in a molecularly-defined population of patients with metastatic castration-resistant prostate cancer (mCRPC).
Presented by Elena Castro, MD, PhD
San Francisco, CA (UroToday.com) In this talk, Dr. Elena Castro gave an overview of the genomic landscape of advanced prostate cancer. It has been shown that in over 70%
San Francisco, California (UroToday.com) Metastatic castration-resistant prostate cancer (mCRPC) is a molecularly heterogeneous disease, with between 20 and 25% of patients with mCRPC harboring deleterious alterations in DNA damage repair genes, including those with direct or indirect roles in homologous recombination repair (HRR).
Presented by Maha Hussain, MD
Barcelona, Spain (UroToday.com) Despite significant progress in systematic therapy, metastatic castration-resistant prostate cancer (mCRPC) continues to be a lethal disease.
Presented by Eleni Efstathiou, MD, PhD
Barcelona, Spain (UroToday.com) Following oral presentation of the PROfound study of olaparib in metastatic castration-resistant prostate cancer (mCRPC) patients with selected homologous recombination repair defects in their tumors, Dr. Eleni Efstathiou discussed the findings and posed the question of whether this study should be considered practice-changing.
Barcelona, Spain (UroToday.com) A proportion of patients with metastatic castration-resistant prostate cancer (mCRPC) have tumor cells harboring homologous recombination repair gene mutations that may confer sensitivity to poly ADP-ribose polymerase (PARP) inhibition.