Translating MAGNITUDE Trial Results Into Clinical Practice


Kim N. Chi, MD, FRCPC, discusses how the findings from the phase 3 MAGNITUDE trial translate into everyday practice.

Kim N. Chi, MD, FRCPC, medical oncologist, vice president, chief medical officer, British Columbia Cancer, professor, Division of Medical Oncology, University of British Columbia, discusses how the findings from the phase 3 MAGNITUDE trial (NCT03748641) translate into everyday practice.

The MAGNITUDE trial is evaluating the combination of niraparib, abiraterone acetate, and prednisone (AAP) for the treatment of patients with BRCA1/2-altered metastatic castration-resistant prostate cancer (mCRPC). Longer follow-up from the second prespecified interim analysis of the MAGNITUDE study showed that there were 212 patients with mCRPC with HRR gene alterations treated with niraparib plus AAP. This included 113 patients who made up the BRCA1/2 subgroup. At a median follow-up of 24.8 months, niraparib given in combination with AAP significantly improved radiographic progression-free survival (rPFS) at 19.5 months vs 10.9 months with placebo (HR, 0.55; 95% CI, 0.39-0.78; nominal P =.0007).

Among the patients with HRR alterations, prolonged rPFS was seen (HR, 0.76; 95% CI, 0.60-0.97; nominal P =.0280) at a median follow-up of 26.8 months.

In addition, researchers looked at pain, health-related quality of life (QOL) and adverse events (AEs). The combination did not worsen pain or QOL compared with placebo, and AEs were minimal across both groups.

Here, Chi also delves into what practical tools or resources can be used to monitor and address the patient-reported outcomes looked at in the trial.


0:09 | I think this reinforces the need to identify patients with BRCA alterations and HRR mutations in general. It emphasizes the recommendations that for all patients with metastatic prostate cancer, we need to be doing genetic testing to understand if their cancers have these. There are many implications to this, so hereditary cancer implications, prognostic implications, but as well, treatment implications, because these patients can be treated with PARP inhibitors. I think this is a standard of care that we should be moving forward with.

0:47 | More and more, we are seeing the ability to incorporate patient-reported outcomes into our everyday practice. This is becoming a standard across many organizations and institutions. Certainly, I encourage its use. We know that monitoring a patient’s quality of life can really improve their outcomes.

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