Efficacy

Efficacy of Lynparza (Olaparib) in Prostate Cancer

Lynparza, also known as olaparib, is a poly (ADP-ribose) polymerase (PARP) inhibitor that has shown efficacy in treating prostate cancer, particularly in patients with mutations in DNA repair genes such as BRCA1/2. The effectiveness of Lynparza in prostate cancer was notably demonstrated in the PROfound study, which was a phase 3 trial focusing on patients with metastatic castration-resistant prostate cancer (mCRPC) who had progressed on prior new hormonal agent treatments and had a qualifying homologous recombination repair (HRR) gene mutation. The study found that Lynparza significantly prolonged radiographic progression-free survival compared to the control group receiving a new hormonal agent of the physician’s choice (enzalutamide or abiraterone).

Patients treated with Lynparza in the PROfound study also showed an improvement in overall survival, although this endpoint was not reached at the interim analysis. The benefit was more pronounced in patients with BRCA1/2 or ATM gene mutations. The results of this trial led to the approval of Lynparza for the treatment of HRR gene-mutated mCRPC after prior treatment with enzalutamide or abiraterone. It is important to note that the use of Lynparza is specifically indicated for patients with HRR gene mutations, which should be identified through genetic testing prior to the initiation of treatment.

Efficacy of Entadfi (Finasteride and Tadalafil) in Prostate Cancer

Entadfi, a combination of finasteride and tadalafil, is not primarily used for the treatment of prostate cancer. Finasteride is a 5-alpha-reductase inhibitor which is commonly used for the treatment of benign prostatic hyperplasia (BPH), and tadalafil is a phosphodiesterase type 5 (PDE5) inhibitor used for erectile dysfunction and also BPH. While finasteride has been studied in the context of prostate cancer prevention in the Prostate Cancer Prevention Trial (PCPT), its role was in reducing the risk of developing prostate cancer, not in the treatment of existing prostate cancer.

The combination of finasteride and tadalafil in Entadfi is designed to address symptoms of BPH and improve urinary flow in men. There is no direct evidence supporting the efficacy of Entadfi in the treatment of prostate cancer. Its use in prostate cancer patients may be more related to managing symptoms associated with BPH or treatment-related side effects rather than treating the cancer itself. Clinical trials and studies have not established Entadfi as a treatment option for prostate cancer, and its use in this context would be considered off-label and not supported by current clinical guidelines.