GU Cancers 2024 | BRCAAway: abiraterone with olaparib in mCRPC with HRR mutations

Sure. I’ll start with the BRCAAway trial first. This is an updated analysis provided by Dr Hussain and a small, randomized phase II trial looking at the combination of abiraterone and the PARP inhibitor olaparib versus olaparib alone versus abiraterone alone. And what she found in this updated analysis is that indeed, the combination was far superior than either agent alone. We already kind of knew this from the PROpel trial, as well as the other PARP inhibitor trials, the MAGNITUDE trial and the TALAPRO-2 trial. However, what was interesting in this trial is that there was a built in crossover, so it gives us an ability to get some insights into combination versus sequential therapy. And what she showed is that the the sequential approach seemed to be less effective than the combination approach. Therefore, it really supports the use of upfront combination therapy. Now, the caveat is this is a small trial with only about 20 patients per arm and really only applies to BRCA 2 patients. Nevertheless, it does support the upfront use of combined AR pathway inhibitors and PARP inhibitors in patients with BRCA 2 alterations.