IUC24433-81 Docetaxel versus olaparib plus abiraterone as first-line treatment in patients with mCRPC: a retrospective single-center analysis

Background Olaparib and abiraterone (Ola+Abi) has emerged as a novel first-line (1L) treatment option for metastatic castration-resistant prostate cancer (mCRPC), but comparisons with docetaxel are lacking. We retrospectively evaluated outcomes of patients treated with either docetaxel (Doc) or Ola+Abi as 1L therapy for mCRPC. Methods This real-world study included patients with mCRPC who received 1L treatment with either Doc or Ola+Abi. Radiographic progression-free survival (rPFS) was assessed using Kaplan–Meier estimates and compared by log-rank test. Results Sixty patients were included: 24 (40%) received Doc and 36 (60%) received Ola+Abi. In the hormone-sensitive (HS) setting, 28 patients (77.8%) in the Ola+Abi group had received Doc, while in the Doc group, 12 patients (50%) had received ADT, 11 (45.8%) enzalutamide and 1 (4.2%) apalutamide. Baseline characteristics were well balanced except for the previous HS disease setting (P = .015), although time to castration resistance was not significantly different (P = .159) (Table 1). Median rPFS was significantly longer with the Ola+Abi group (14.5 months, 95%CI 10.2-NR) compared to Doc (8.2 months, 95%CI 3.5-10.9), P = .004 (Figure 1). Conclusions Ola+Abi was associated with improved rPFS compared to Doc as 1L treatment for mCRPC. Despite limitations due to retrospective design, small sample size, and possible differences in characteristics between the 2 groups, these results suggest different clinical outcomes between treatment strategies, which warrant overall survival data.