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 researchers.
The Phase III AMPLITUDE trial, published in Nature Medicine, tested the addition of niraparib, a type of targeted cancer drug known as a PARP inhibitor1, to the standard treatment of abiraterone acetate and prednisone (AAP).2
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).
These genes help repair damaged DNA and when they are faulty, cancer cells can grow and spread more aggressively. Approximately one in four people with advanced prostate cancer at this stage have alterations in HRR genes, such as BRCA1, BRCA2, CHEK2, and PALB2.
The standard treatment for advanced prostate cancer is currently AAP (or similar drugs, with docetaxel chemotherapy offered to approximately one-in-five patients) but these mutations make the cancer more aggressive and consequently disease progression on standard treatment is often far quicker with shorter life expectancies.
Led by John Black Charitable Foundation Professor of Oncology Gerhardt Attard from UCL Cancer Institute, the trial enrolled 696 men across 32 countries with a median age of 68. Half received the new combination therapy (niraparib plus APP), while the other half received standard treatment with a placebo. Of all the patients, more than half (55.6%) had alterations in the BRCA1 or BRCA2 genes.
The trial was double-blind, meaning neither patients nor doctors knew which treatment was being administered.
