# Durable complete radiographic and biochemical response to olaparib in BRCA2-mutated metastatic castration-resistant prostate cancer: a long-term responder case

## TL;DR

A man with BRCA2-mutated prostate cancer achieved long-term remission using olaparib, highlighting the drug's potential for this rare condition.

## Contribution

Demonstrates a durable complete response to olaparib in BRCA2-mutated metastatic castration-resistant prostate cancer.

## Key findings

- Olaparib monotherapy led to undetectable prostate-specific antigen for over 27 months.
- Complete resolution of bone metastases was confirmed by bone scan index.
- Early genomic testing can identify patients likely to benefit from PARP inhibitors.

## Abstract

Poly(ADP-ribose) polymerase inhibitors are an important option for metastatic castration-resistant prostate cancer (mCRPC) with homologous recombination repair gene alterations, although durable complete responses remain rare. We report a 72-year-old man with BRCA2-mutated mCRPC who achieved a sustained complete response to olaparib monotherapy. After progression on androgen deprivation therapy, abiraterone, enzalutamide, and docetaxel, genomic profiling identified a pathogenic BRCA2 alteration. Olaparib induced an undetectable prostate-specific antigen within three months, maintained for over 27 months, with complete resolution of bone metastases. This case highlights the potential for durable responses to olaparib and the importance of early genomic testing.

•BRCA2-mutated mCRPC achieved durable complete response with olaparib monotherapy•Comprehensive genomic profiling identifies candidates for PARP inhibitor therapy•Bone scan index objectively confirmed deep radiographic response•Selected patients may achieve long-term benefit without cumulative toxicity

BRCA2-mutated mCRPC achieved durable complete response with olaparib monotherapy

Comprehensive genomic profiling identifies candidates for PARP inhibitor therapy

Bone scan index objectively confirmed deep radiographic response

Selected patients may achieve long-term benefit without cumulative toxicity