Camille Hertzka, vice president, head of oncology, US Medical, AstraZeneca, discusses why so much excitement has been generated for the use of olaparib (Lynparza) in the first line for patients with metastatic castrate-resistant prostate cancer.
There is a lot of unmet need in metastatic castrate-resistant prostate cancer (mCRPC), so it’s important that we bring newer, more impactful medicine to the frontline setting, emphasized Camille Hertzka, vice president, head of oncology, US Medical, AstraZeneca.
How do you expect newer drugs, such as PARP inhibitors, to be received as first-line treatment for mCRPC?
I would say that because Lynparza [olaparib] was already approved in this metastatic castrate-resistant prostate cancer—it was a monotherapy for selected patient populations—we expect to have a lot of enthusiasm. At the time of the presentation of PROfound initially, there was a lot of excitement. The importance of the introduction of this new treatment was really raising a lot of hope and excitement in this environment.
In addition to that, the safety profile of olaparib is well known and manageable, which is important when you introduce a new treatment in the first-line setting. Now, I would say that because olaparib is well established in the US as a standard of care in prostate cancer in HRR [mutation] patients, it will really help going beyond to a broader patient population with the first line.
We know that only 25% to 30% of patients in first-line metastatic castrate-resistant prostate cancer have an HRR mutation, so that means that there is really a lot of unmet need that is remaining in the broader patient population. And PROpel was really eagerly awaited, as it was leveraging this combination of 2 very active treatments that are now well known in prostate cancer—olaparib and abiraterone—to leverage the potential of each medicine to increase the activity of the other one.
When PROpel was presented at ASCO GU, medical oncologists and urologists, all of them have been unanimous on the importance of these data and the unprecedented benefit observed, with more than 2 years median radiological PFS [progression-free survival] as really the longest reported PFS in the setting. With that, it’s also important to remember that if you look at the overall outcome of patients with this advanced disease, castrate-resistant prostate cancer, we know that patients usually receive only 1 median treatment. In fact, only half of the patients received a second line of treatments, which means that it’s really important to bring newer medicine and more impactful medicine to the frontline setting, as some patients might not get a chance to receive a second-line treatment.
With the improvement that we’ve seen in the study, we really believe it’s going to be practice changing and will help so many more patients.