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PROpel Olaparib Abiraterone — SCE Medical Oncology MCQ

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HardUrological CancersPROpel Olaparib AbirateroneSCE Medical Oncology

A 62-year-old with newly diagnosed metastatic castration-resistant prostate cancer and a germline BRCA2 pathogenic variant is being counselled about the PROpel evidence. Which trial result is accurate?

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Correct answer: EOlaparib plus abiraterone improved radiographic progression-free survival

PROpel demonstrated improved radiographic progression-free survival from adding olaparib to first-line abiraterone in metastatic castration-resistant prostate cancer. Olaparib plus abiraterone improved radiographic progression-free survival after docetaxel: PROpel enrolled first-line metastatic castration-resistant disease rather than requiring prior docetaxel. Olaparib plus abiraterone improved overall survival in homologous-recombination-proficient disease: the most established reported primary benefit was radiographic progression-free survival, with greatest biological relevance in HRR-deficient disease. Olaparib plus enzalutamide improved radiographic progression-free survival first line: enzalutamide was not the androgen-receptor partner studied in PROpel. Olaparib monotherapy improved first-line radiographic disease control: the trial evaluated olaparib added to abiraterone rather than olaparib monotherapy.

Reference: Lynparza UK summary of product characteristics (Current UK SmPC, accessed July 2026): https://www.medicines.org.uk/emc/product/9488/smpc; NICE NG131 prostate cancer: recommendations (Updated December 2021; current surveillance): https://www.nice.org.uk/guidance/ng131/chapter/Recommendations