niraparib + abiraterone acetate + prednisone

This combination therapy consists of niraparib, a small molecule inhibitor of poly(ADP-ribose) polymerase (PARP) enzymes 1 and 2, and abiraterone acetate, a small molecule inhibitor of the CYP17A1 enzyme, typically administered alongside prednisone. Niraparib functions by impeding DNA repair mechanisms, particularly in cells with homologous recombination repair (HRR) deficiencies, leading to synthetic lethality. Abiraterone acetate inhibits androgen biosynthesis in the testes, adrenal glands, and prostate tumor tissue by blocking 17α-hydroxylase/C17,20-lyase activity. The University of Maryland, Baltimore is investigating this combination in the Phase 2 KNIGHTS trial for patients with high-risk metachronous oligometastatic hormone-sensitive prostate cancer (mHSPC) who harbor specific genomic alterations such as ATM, BRCA1/2, Rb1, and TP53. The treatment is often evaluated in conjunction with metastasis-directed therapy, such as stereotactic ablative radiation (SABR), and standard androgen deprivation therapy (ADT).

Brand names

Akeega

Other names

niraparib + abiraterone acetateniraparib/abiraterone acetate combinationKNIGHTS trial regimen