Dr. Gulley on Take Home Message With Olaparib Plus Durvalumab in mCRPC

James Gulley, MD, PhD, chief, Genitourinary Malignancies Branch, and director, Medical Oncology Service at the National Cancer Institute, discusses the take-home message with the combination of olaparib (Lynparza) plus durvalumab (Imfinzi) in metastatic castration-resistant prostate cancer (mCRPC).

A phase II study of olaparib and durvalumab presented at the 2018 Genitourinary Cancers Symposium aimed to see if the combination of a PARP inhibitor, olaparib, with a PD-L1 inhibitor, durvalumab, could lead to immune responses across an unselected group of patients. This included patients who did not have a DNA damage pathway mutation. Investigators reported that in the first 17 patients, the combination was safe and about half of the patients experience prostate-specific antigen (PSA) declines of at least 40%.

Gulley says that the take-home message from this research is that there is an early signal of activity for this combination, but the mechanism of action is not understood yet. Many of the patients who responded to the combination did not have DNA damage response pathway mutations, and next steps with this data will aim to understand the immune activity in this population.