A combination of three drugs — the targeted therapy niraparib together with standard abiraterone and prednisone treatment — has shown a significant ability to slow the progression of one of the most aggressive forms of prostate cancer. The findings come from researchers at University College London and were published in Nature Medicine.

The study analyzed data from 696 men across 32 countries, all diagnosed with metastatic prostate cancer and carrying mutations in genes responsible for repairing damaged DNA — a process known as homologous recombination repair (HRR). Defects in these genes make tumors more aggressive and resistant to standard therapies.

In the clinical trial, half of the participants received standard therapy (abiraterone + prednisone), while the other half received the same regimen with the addition of niraparib — a PARP inhibitor that targets tumor cells with impaired DNA repair mechanisms.

After 30 months of follow-up, researchers found that adding niraparib reduced the risk of disease progression by 37% compared to standard treatment alone. Among patients with BRCA1/2 mutations, the reduction was even greater — nearly 48%. Moreover, the time until symptom worsening was twice as long in the combination therapy group (16% versus 34% in the control group).

“While standard treatment regimens are effective for most patients, about a quarter of those with HRR gene mutations respond much less favorably. Adding niraparib helps delay relapse and may potentially extend survival,” said study lead Professor Gerhardt Attard.

According to him, the findings highlight the importance of genetic testing at the time of diagnosis.

“If a patient is found to have mutations in one of these genes, physicians can consider prescribing niraparib, carefully weighing its benefits against potential side effects,” he added.