A plain language summary of the results from the MAGNITUDE study assessing how effective and how safe niraparib and abiraterone acetate with prednisone is in patients with metastatic castration-resistant prostate cancer
Creators: name: N., Kim
name: Rathkopf, Dana
name: Smith, Matthew R.
name: Efstathiou, Eleni
name: Attard, Gerhardt
name: Olmos, David
name: Lee, Ji Youl
name: Small, Eric J.
name: de Santana Gomes, Andrea J. Pereira
name: Roubaud, Guilhem
name: Saad, Marniza
name: Zurawski, Bogdan
name: Sakalo, Valerii
name: Mason, Gary E.
name: Francis, Peter
name: Wang, George
name: Wu, Daphne
name: Diorio, Brooke
name: Lopez-Gitlitz, Angela
name: Sandhu, Shahneen
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Genetics
subject: FOS: Biological sciences
subject: Molecular Biology
subject: Immunology
subject: FOS: Clinical medicine
subject: Cancer
subject: Infectious Diseases
subject: FOS: Health sciences

description: <b>What is this summary about?</b> This is a summary of the MAGNITUDE clinical study that was published in the <i>Journal of Clinical Oncology</i> (March 2023) and in <i>Annals of Oncology</i> (September 2023). Researchers looked at the combination of <b>niraparib</b> and <b>abiraterone acetate with prednisone</b> as a first treatment for adult patients with <b>metastatic castration-resistant prostate cancer.</b> Researchers wanted to know how effective and safe niraparib + abiraterone acetate with prednisone is in patients whose cancers had certain <b>gene</b> changes. Researchers focused on genes related to <b>homologous recombination repair (HRR)</b>, a normal process that repairs damaged DNA.The best understood HRR genes are <b><i>BRCA1</i></b> and <b><i>BRCA2</i></b> (which code for BReast CAncer susceptibility 1 and 2 proteins) that are changed in 3–13% of patients with metastatic castration-resistant prostate cancer. We refer to these genes as <i>BRCA1/2</i>.Compared with cancers that lack these changes, cancers with changes in HRR genes (<b>HRR+</b>) may not respond as well to treatments that are normally used for metastatic castration-resistant prostate cancer, such as abiraterone acetate with prednisone. Researchers focused on genes related to <b>homologous recombination repair (HRR)</b>, a normal process that repairs damaged DNA. The best understood HRR genes are <b><i>BRCA1</i></b> and <b><i>BRCA2</i></b> (which code for BReast CAncer susceptibility 1 and 2 proteins) that are changed in 3–13% of patients with metastatic castration-resistant prostate cancer. We refer to these genes as <i>BRCA1/2</i>. Compared with cancers that lack these changes, cancers with changes in HRR genes (<b>HRR+</b>) may not respond as well to treatments that are normally used for metastatic castration-resistant prostate cancer, such as abiraterone acetate with prednisone. <b>What were the main conclusions reported by the researchers?</b> Patients who had BRCA1/2 changes had a longer time (16.6 months) before their cancer worsened compared with those who did not (10.9 months). Patients with HRR+ metastatic castration-resistant prostate cancer taking niraparib + abiraterone acetate with prednisone had a longer time (16.5 months) before their cancer worsened (tumor increased in size, cancer spread, or death) compared with those taking <b>placebo</b> + abiraterone acetate with prednisone (13.7 months). Patients taking niraparib + abiraterone acetate with prednisone had more <b>side effects</b> (99.1%) than those taking placebo + abiraterone acetate with prednisone (94.3%). These were well-known side effects of these medicines and generally managed by pausing treatment or lowering the dose. These were well-known side effects of these medicines and generally managed by pausing treatment or lowering the dose. <b>What are the key takeaways?</b> Patients with HRR+ metastatic castration-resistant prostate cancer, especially those with BRCA1/2 changes, have better outcomes with niraparib + abiraterone acetate with prednisone compared with placebo + abiraterone acetate with prednisone. These results show the importance of testing for HRR gene changes to select treatments that are most likely to lead to improved outcomes for these patients. This is an abstract of the Plain Language Summary of Publication article. View the full Plain Language Summary PDF of this article to read the full-text A PDF version of this infographic is available as supplemental material.