New evidence for world's first ever precision medicine for prostate cancer

The European Society for Medical Oncology (ESMO) conference in Barcelona came to a close today, after a jam-packed schedule of cancer research breakthroughs. In prostate cancer, results on the drug olaparib could mean it's set to become the world's first precision medicine for prostate cancer. 

Results from the PROfound trial presented at ESMO today showed ovarian and breast cancer drug, olaparib (Lynparza), delayed the progression of advanced prostate cancer in men whose cancer cells have faulty DNA repair genes by around four months, compared to standard treatments like enzalutamide and abiraterone. Early results also showed olaparib could extend survival by over three months, however more evidence is needed to prove that the 4-month delay in progression seen does in fact translate to increased survival in men. 

The results are thought to be the final piece of the puzzle needed to prove that olaparib is an effective treatment for this group of men. 

How does Olaparib work?

Olaparib is a type of drug known as a PARP inhibitor, which targets cancer cells' ability to repair damage to their DNA. Previous evidence, including research funded by Prostate Cancer UK, showed that men with defects in their DNA damage repair genes were likely to respond to PARP inhibitors like olaparib.

From the results of the phase III clinical trial, PROfound, released today, olaparib has been shown to be effective in men whose cancer has a mutation in one of 15 genes that are involved in repairing damage to DNA,  including the BRCA1, BRCA2 and ATM genes. 

What does this mean for men with advanced prostate cancer?

This research could make a huge difference to men with advanced prostate cancer whose cancer cells have mutations in genes like BRCA, by offering them a brand-new treatment option after their cancer has become resistant to hormone therapy.

It’s also the first example of a precision medicine for prostate cancer, which uses a detailed understanding of the tumour's genetics to work out which men will benefit. We know that each man’s cancer is different, which is why Prostate Cancer UK have been championing research into a precision-approach to treatments since 2014. Olaparib marks the first treatment in a new, targeted approach to treating prostate cancer.

Dr Matthew Hobbs, Deputy Director of Research at Prostate Cancer UK said: “This hugely exciting result represents a revolution in the treatment of prostate cancer. It finally brings prostate cancer medicine into the 21st century by giving us, for the first time ever, a therapy that makes use of genetic testing of the tumour to work out which men will benefit.

“This kind of precision medicine approach is already used to treat other cancers, and we hope olaparib will become the first of many treatments for prostate cancer which are based on this sort of detailed understanding of an individual man’s tumour.

“These impressive results build on earlier research funded by Prostate Cancer UK including a study funded in partnership with Movember, that showed which patients were most likely to respond to olaparib and the genetic tests needed to find them. It’s important to note that these tests are specifically designed to identify cancers that are likely to respond to this type of treatment. This is different to genetic testing to work out if inherited mutations might make a man more likely to get prostate cancer in the future – an area which is still the subject of ongoing research.

“We have already committed millions of pounds to fund further research to expand precision treatment of prostate cancer so that more men can benefit. In the meantime, our immediate priority is to make sure that this latest medicine and its associated tests are made available as soon as possible for men with hormone resistant advanced prostate cancer.”

How to access olaparib

These results are an exciting and promising step forward to bringing olaparib to men as a new, precision treatment for advanced prostate cancer. 

Prostate Cancer UK's first priority now is to work together with the pharmaceutical company, healthcare regulators, researchers and men to make sure that all men in the UK who could benefit from olaparib can access it on the NHS.

In the mean time, PARP inhibitors (drugs like olaparib) can be accessed on clinical trials. There are a number of trials currently recruiting which are testing olaparib at different stages of treatment. If you are thinking about taking part in a clinical trial, you should speak to your clinician or contact our specialist nurses on 0800 074 8383 for more information about what to do next and what might be involved.

Based on the findings released today, Prostate Cancer UK would recommend that, once olaparib becomes available, men with advanced prostate cancer that has stopped responding to abiraterone or enzalutamide should speak to their medical team about having their tumour tissue tested to see if they could benefit from olaparib. 

If you have any concerns, you should speak to your GP, or call our specialist nurses on 0800 074 8383, who will be able to advise you further.