Niraparib Plus AAP Offers Satisfactory Patient-reported Outcomes for mCRPC With BRCA1/2 Alterations

New results from the MAGNITUDE trial’s final analysis were presented at the 2024 American Society of Clinical Oncology Genitourinary Cancers Symposium, offering a look at the effects of niraparib with abiraterone acetate and prednisone (AAP) on the pain, health-related quality of life (HRQoL), and side effect burden (PRO) of patients with metastatic castration-resistant prostate cancer (mCRPC).

Earlier results of the study demonstrated that niraparib plus AAP offered significantly improved radiographic progression-free survival (PFS) in patients with mCRPC and BRCA1/2 alterations, as well as prolongations in time to symptomatic progression and cytotoxic chemotherapy compared with placebo plus AAP.

Patients in the MAGNITUDE trial were randomized 1:1 to receive niraparib plus AAP or placebo plus AAP, each administered orally in 28-day cycles. PRO measurements began on day 1 of the specified cycles and included the Brief Pain Inventory-Short Form (BPI-SF) and Functional Assessment of Cancer Therapy–Prostate (FACT-P). Time to deterioration (TTD) in pain and changes from baseline in HRQoL were compared between the 2 treatment arms.

The PRO compliance for FACT-P and BPI-SF was over 85% in 225 patients with BRCA1/2-altered mCRPC. At baseline, the mean BPI-SF pain score and FACT-P total score was 1.09 and 116.33, respectively, in the niraparib plus AAP arm. In the placebo plus AAP arm, the mean BPI-SF pain score and FACT-P total score was 1.35 and 114.8, respectively.

The median TTD in BPI-SF worst pain and pain interference was not reached for the niraparib plus AAP arm, and was 32.2 and 41.5 months in the placebo plus AAP arm, respectively. Average pain and FACT-P PRS was 30.4 and 7.2 months in the niraparib plus AAP arm, and 14.8 and 4.6 months in the placebo plus AAP arm.

HRQoL was maintained in the niraparib plus AAP treatment arm, and patients experienced minimal side effect bother from treatment. These new data further support the use of niraparib plus AAP for patients with mCRPC and BRCA1/2 alterations.