Fred Saad, MD, FRCS, Highlights Positive OS Trend With Abiraterone and Olaparib in mCRPC But Cites Need for Longer Follow-up

Abiraterone and olaparib continued to demonstrate a positive trend in overall survival (OS) in patients with metastatic castration-resistant prostate cancer, according to Fred Saad, MD, FRCS, though he stated that longer follow-up is needed to confirm the benefit.

Fred Saad, MD, FRCS, a professor and chairman of Urology, and director of Genitourinary Oncology at the University of Montreal Hospital Center, spoke with CancerNetwork® during the 2022 European Society for Medical Oncology Congress (ESMO) about updated findings from the phase 3 PROpel trial (NCT03732820), assessing abiraterone (Zytiga) and olaparib (Lynparza) in patients with metastatic castration-resistant prostate cancer (mCRPC).

In patients who received first-line abiraterone and olaparib or abiraterone and placebo, the median overall survival (OS) was not reached, having achieved a maturity of 40.1% (NR; HR, 0.83; 95% CI, 0.66-1.03; P = .11). Moreover, he described the benefit patients with BRCA mutations experienced after receiving the regimen.


What the data we presented here adds to what has already been presented and published is that as the data mature, we're seeing that this trend in overall survival [OS] continues to improve. [It] is very reassuring that we're not seeing a disappearance of that [OS] advantage; it’s actually getting better as the data continues to mature. We’re still only at [approximately] 40% of deaths. The median survival has still not been reached in either arm, which is a good thing for patients, but it tells us that we need to have more time for definite answers regarding [OS].

It also adds to our understanding of the importance of patients with or without mutations, especially BRCA mutations. For [those] who are still wondering about the actual benefit, this answers several questions. Clearly, BRCA-mutated patients are getting tremendous benefit.


Saad F, Armstrong AJ, Thiery-Vuillemin A, et al. 1357O - Biomarker analysis and updated results from the Phase III PROpel trial of abiraterone (abi) and olaparib (ola) vs abi and placebo (pbo) as first-line (1L) therapy for patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol. 2022;33(suppl 7):S616-S652. doi:10.1016/annonc/annonc1070