A groundbreaking Phase III clinical trial led by UCL researchers has demonstrated that combining the drug niraparib with standard prostate cancer treatment significantly delays disease progression in men with advanced prostate cancer who have specific genetic mutations in homologous recombination repair (HRR) genes, such as BRCA1 and BRCA2.

The study involved 696 men from 32 countries, with an average age of 68, all of whom had DNA repair gene alterations, notably in BRCA1 and BRCA2, which are crucial for homologous recombination repair.

Patients receiving the combination treatment experienced a 37% reduction in the risk of cancer growth overall, and a 48% reduction among those with BRCA1 or BRCA2 mutations, compared to standard care alone.

While the data on survival outcomes are still immature, the combination therapy showed promise in delaying cancer recurrence and potentially extending survival, with a trend toward improved overall survival observed, though longer follow-up is needed.

The study also indicated a trend toward better overall survival with niraparib, but longer-term data are required to confirm potential life expectancy benefits.

Researchers are advocating for wider genetic testing at diagnosis to identify patients who could benefit from targeted therapies like niraparib, which may delay disease recurrence and extend life expectancy.

Professor Gerhardt Attard emphasized that genomic testing is essential to determine eligibility for targeted treatments, especially for patients with HRR gene mutations, where niraparib has already received approval.

However, the combination therapy was associated with increased side effects, including anemia and high blood pressure, and a higher incidence of treatment-related mortality, with 25% of patients requiring blood transfusions.

Despite these side effects, the potential benefits in delaying disease progression highlight the importance of weighing risks and benefits and suggest a need for widespread genetic testing to identify suitable candidates.

Experts note that further research is necessary to confirm long-term survival benefits and to evaluate the impact of advanced imaging techniques and broader genetic testing on treatment outcomes.

Given that prostate cancer is highly prevalent globally, with approximately 1.5 million new cases annually and around 12,000 deaths in the UK each year, developing more effective, targeted treatments is of critical importance.

The article also references increased advocacy for early screening, inspired by cases like Sir Chris Hoy, who was diagnosed with terminal prostate cancer at age 47, and the increased testing following King Charles's prostate cancer treatment, which was detected during treatment for an enlarged prostate.