A major international trial offers fresh hope to men battling advanced prostate cancer, suggesting a new drug combination could significantly delay the disease's progression in patients with specific genetic mutations.
Scientists at University College London (UCL) led the study, which investigated adding niraparib—a targeted cancer drug known as a PARP inhibitor—to the standard hormone therapy, abiraterone acetate and prednisone (AAP).
Targeting Aggressive Gene Mutations
The trial focused on patients with advanced prostate cancer that had spread to other parts of the body (metastatic) and who were starting their first line of treatment. Crucially, all participants had alterations in genes involved in Homologous Recombination Repair (HRR), such as BRCA1, BRCA2, CHEK2, and PALB2.
These HRR genes typically help repair damaged DNA. When faulty, these genes allow cancer cells to grow and spread more aggressively. About one in four people with advanced prostate cancer at this stage have these HRR gene alterations.
The standard treatment (AAP or similar drugs) is less effective for these patients because the mutations make the cancer more aggressive, leading to quicker disease progression and shorter life expectancies.
Trial Results Show Significant Impact
The double-blind trial involved 696 men across 32 countries. Half received the new combination therapy (niraparib plus AAP), while the other half received the standard treatment with a placebo.
The findings, published in Nature Medicine, showed compelling results after an average follow-up of 30.8 months:
Reduced Risk of Growth: Niraparib reduced the risk of cancer growth by 37% in all treated patients compared to AAP alone.
Targeted Success: The risk reduction was even higher—48%—in the subgroup of patients with BRCA1 or BRCA2 mutations.
Delayed Symptoms: The time until symptoms worsened was twice as long for the niraparib group, cutting the percentage of patients with notable symptom worsening from 34% to 16%.
Expert View and Next Steps
Professor Gerhardt Attard of UCL’s Cancer Institute, the study leader, stated, "We now know that prostate cancers with alterations in HRR genes represent a significant patient group whose disease comes back fast and follows an aggressive path." He added, "By combining with niraparib, we can delay the cancer returning and hopefully significantly prolong life expectancy."
Professor Attard noted that the findings strongly support widespread genomic testing at diagnosis to identify patients who would benefit most from this targeted treatment.
While the results are promising, the research team observed only a trend toward improved overall survival, stating that a longer follow-up is needed to confirm if niraparib improves life expectancy. They also noted that side effects, such as anemia and high blood pressure, were more common in the niraparib group.
Further research is planned to confirm the long-term survival benefits and analyze the impact of newer diagnostic techniques.
Disclaimer: This is published only for health awareness and informational purposes. It's not a substitute for your professional medical advice. You must consult a doctor/healthcare professional regarding your specific health concerns.
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