ArticleThe oncologist2026
Matching-adjusted indirect comparisons of PARP inhibitor combinations in metastatic castration-resistant prostate cancer across key populations.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundWithout head-to-head trials comparing talazoparib plus enzalutamide (TALA+ENZA), olaparib plus abiraterone acetate and prednisone (OLAP+AAP), and niraparib plus abiraterone acetate and prednisone (NIRA+AAP) as first-line treatments for metastatic castration-resistant prostate cancer (mCRPC), treatment selection remains challenging. This study estimated the relative efficacy of TALA+ENZA vs OLAP+AAP and NIRA+AAP in unselected, homologous recombination repair (HRR)-deficient, and BRCA-mutated (BRCAm) populations.
methodsUnanchored matching-adjusted indirect comparisons (MAICs) were conducted using individual patient data from TALAPRO-2 (TALA+ENZA) and published summary-level data from PROpel (OLAP+AAP) and MAGNITUDE (NIRA+AAP). TALAPRO-2 patients meeting PROpel/MAGNITUDE eligibility criteria were included; remaining patients were reweighted to align on key baseline characteristics. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for radiographic progression-free survival (rPFS) and overall survival (OS).
resultsIn unselected patients, TALA+ENZA significantly prolonged rPFS vs OLAP+AAP (HR: 0.747; 95% CI, 0.583, 0.957), with no OS difference (HR: 0.821; 95% CI, 0.649, 1.039). In HRR-deficient patients, TALA+ENZA significantly prolonged rPFS vs OLAP+AAP (HR: 0.648; 95% CI, 0.423, 0.992), with no OS difference (HR: 0.834; 95% CI, 0.569, 1.223). Comparisons with OLAP+AAP in BRCAm were infeasible. Compared with NIRA+AAP, TALA+ENZA significantly prolonged rPFS and OS in HRR-deficient (HR: 0.406; 95% CI, 0.251, 0.655; HR: 0.554; 95% CI, 0.340, 0.902) and BRCAm patients (HR: 0.394; 95% CI, 0.222, 0.698; HR: 0.472; 95% CI, 0.247, 0.902).
conclusionsMAICs showed improved clinical benefit with TALA+ENZA vs OLAP+AAP and NIRA+AAP across multiple mCRPC populations and endpoints. Despite limitations of indirect comparisons, findings support TALA+ENZA as a first-line treatment option for mCRPC.
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