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Olaparib Monotherapy Yields Good PSA Response Rates in Prostate Cancer

Response rates seen in patients with high-risk biochemically recurrent prostate cancer after radical prostatectomy

By Elana Gotkine HealthDay Reporter

MONDAY, Aug. 26, 2024 (HealthDay News) — For men with high-risk biochemically recurrent prostate cancer, olaparib monotherapy yields good prostate-specific antigen (PSA) response rates, especially among those with BRCA2, according to a study published online Aug. 22 in JAMA Oncology.

Catherine H. Marshall, M.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues examined the activity of olaparib monotherapy among patients with high-risk biochemically recurrent prostate cancer after radical prostatectomy in a phase 2, single-arm nonrandomized controlled trial. A total of 51 male patients were enrolled and received treatment with olaparib twice daily until doubling of baseline PSA, clinical or radiographic progression, or unacceptable side effects.

The researchers found 13 participants (26 percent) had a 50 percent or higher decline in PSA from baseline (PSA50); all were within the homologous recombination repair-positive group (13 of 27; 48 percent). A PSA50 response occurred in all 11 participants with BRCA2 alterations. Fatigue, nausea, and leukopenia were common adverse events (63, 55, and 43 percent, respectively), which were consistent with known adverse effects of olaparib.

“Molecularly targeted therapies in select patient populations may be a reasonable treatment strategy for some patients with recurrent prostate cancer, even in the absence of androgen deprivation therapy,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including AstraZeneca, which provided olaparib and financial support for the study.

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