With multiple PARPi + ARSI combinations now approved, how are you selecting which combination to use for a patient with BRCA mutated mCRPC?

As of this writing, we have 3 choices for a man with mCRPC and a BRCA2 mutation who has never had a prior ARSI and is now progressing on ADT with or without docetaxel in the mHSPC setting or ADT in the nmCRPc setting. Abiraterone plus olaparib has the longest follow up and a clearly significant over...

Updated answer:

I do not feel that the data is so much different that I always prioritize saving abiraterone for mCRPC in being able to specifically choose the abi/olaparib combination. I still focus on making the best choice in the mHSPC setting whether that is using ADT/abiraterone or direct AR an...

As we have the recent approval of 3 separate combinations, and assuming accessibility is not an issue, I review the patient’s co-morbidities, concomitant medications, issues of monitoring, and sometimes pill burden. Importantly, shared decision-making is a key component.