Rana McKay, MD, outlines key findings from the phase 2 COMRADE trial

Data from the phase 2 COMRADE trial (NCT03317392) were presented at the 2025 American Society of Clinical Oncology Annual Meeting in Chicago, Illinois.¹ Overall, the trial showed that reduced-dose olaparib (Lynparza) combined with radium-223 (Ra-223, Xofigo) significantly improved radiographic progression-free survival (rPFS) over Ra-223 alone in patients with castration-resistant prostate cancer (CRPC) and bone metastases.

In a recent interview with Urology Times®, presenting author Rana R. McKay, MD, FASCO, details the key efficacy and safety findings from the study. McKay is a GU medical oncologist at the University of California, San Diego.

In total, the COMRADE trial enrolled 120 patients who were randomly assigned to receive Ra-223 plus olaparib (arm A; n = 61) or Ra-223 alone (arm B; n = 59).

Overall, the median rPFS was 8.9 months in arm A vs 4.7 month in arm B (HR, 0.47). The addition of olaparib improved rPFS regardless of HRR mutation status (HRR+: HR, 0.52; 80% CI, 0.26 to 1.04; HRR-: HR, 0.54; 80% CI, 0.38 to 0.77).

The greatest benefit was observed in patients who had not received prior docetaxel. Among those patients, the median rPFS was 13.7 months for the olaparib plus Ra-223 arm vs 5.7 months in the Ra-223–alone arm (HR 0.24; 1-sided 90% CI, 0.15 to 0.40).

Regarding safety, grade 3 or higher treatment-related adverse events (TRAEs) were reported in 56% of patients in arm A vs 33% of patients in arm B. The most common TRAEs were anemia (22.0% vs 16.0%, respectively), lymphocyte decrease (31% vs 9%), platelet decrease (6.8% vs 3.6%), and neutrophil decrease (5.1% vs 7.3%).

REFERENCE

1. McKay RR, Xie W, Ajmera A, et al. A multicenter, randomized, phase 2, investigator-initiated ETCTN trial of olaparib + radium-223 vs. radium-223 in men with castration-resistant prostate cancer (CRPC) with bone metastases (BM) (COMRADE): Initial efficacy and biomarker analysis. J Clin Oncol. 2025;43(suppl 17):5007. doi:10.1200/JCO.2025.43.16_suppl.5007