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From Genomic Testing to Olaparib Treatment: Real-World Utilization and Outcomes in BRCA-Mutated Metastatic
Dianne Bosch1, Kim J M van der Velden2, Aart Beeker3
1Department of Urology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. Dianne.Bosch@radboudumc.nl.
Drugs - Real World Outcomes
|May 9, 2026
Summary
Genomic testing for prostate cancer with BRCA mutations remains limited. Olaparib monotherapy showed better overall survival in taxane-naïve patients, suggesting a benefit in earlier treatment lines.
Area of Science:
- Oncology
- Genetics
- Pharmacology
Background:
- Olaparib, a PARP inhibitor, was approved in the Netherlands in November 2020 for metastatic castration-resistant prostate cancer (mCRPC) with BRCA mutations (BRCAm).
- Real-world outcomes may differ from clinical trial data due to patient selection.
Purpose of the Study:
- To assess genomic testing practices for BRCAm in mCRPC.
- To evaluate the real-world use and outcomes of olaparib monotherapy in this population.
Main Methods:
- Retrospective analysis of the Dutch CAPRI-3 registry (2016-2021) from ten hospitals.
- Included mCRPC patients receiving olaparib post-approval (November 2020).
- Grouped patients into taxane-naïve (TN) and post-taxane (PT) cohorts; primary endpoint was overall survival (OS).
Main Results:
- Genomic testing was performed in 23.4% of 1996 mCRPC patients, identifying BRCAm in 11.3%.
- Of 35 eligible BRCAm patients, 27 received olaparib.
- Median OS was significantly longer in TN (28.7 months) versus PT (10.5 months) patients (p=0.003).
Conclusions:
- Genomic testing for BRCAm in mCRPC is limited and varies between centers.
- Most eligible patients received olaparib.
- Taxane-naïve patients demonstrated a greater benefit from olaparib monotherapy.
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