A new drug combination could significantly delay the progression of a life-threatening form of prostate cancer in men with specific genetic mutations, finds a major international trial led by UCL.
The AMPLITUDE trial, published in Nature Medicine, tested the addition of niraparib, a type of targeted cancer drug known as a PARP inhibitor, to the standard treatment of abiraterone acetate and prednisone (AAP).
The study focused on patients diagnosed with advanced prostate cancer where cells have spread to other parts of the body, who were starting their first treatment and who also had alterations in genes involved in an essential type of DNA defect repair, known as homologous recombination repair (HRR).
The trial, led by Prof Gerhardt Attard from UCL Cancer Institute which receives BRC support, found that, overall, niraparib reduced the risk of cancer growth by 37% compared to AAP alone in all patients and by 48% in the subgroup of patients with BRCA1 or BRCA2 mutations.
The time until symptoms got worse was twice as long for patients who received niraparib compared to those who received a placebo, reducing the number of patients who had notable worsening in symptoms from 34% to 16%.
Researchers also observed a trend toward improved overall survival in the niraparib group. However, a longer follow-up is needed to confirm that starting niraparib for this population of patients improves life expectancy.
Prof Attard said: "Although current standard treatments are very effective for the majority of patients with advanced prostate cancer, a small but very significant proportion of patients have limited benefit. We now know that prostate cancers with alterations in HRR genes account for a significant group of patients whose disease recurs quickly and has an aggressive course. By combining with niraparib we can delay the cancer returning and hopefully significantly prolong life expectancy.”
Image: Adobe Stock / RF Science
