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Staying ahead of the curve is crucial in the ever-evolving oncology landscape. Cadence’s Key Opinion Leader (KOL) Market Snapshot Reports offer a unique opportunity to tap into the insights of leading physicians, providing a glimpse into future clinical and regulatory developments. The first report in this series focused on prostate cancer, offering valuable insights that have proven predictive of real-world outcomes.

Consider the case of metastatic, castration-resistant prostate cancer (mCRPC). Patients with mCRPC often receive an androgen receptor pathway inhibitor (ARPI) as one of their first systemic therapies. In addition, patients whose tumors have homologous-repair deficient (HRD) genes, such as BRCA1 or BRCA2, are also eligible for a PARP inhibitor, most likely olaparib, after being treated with an ARPI.

Several pharmaceutical companies, including AstraZeneca, Pfizer, and GSK, have been developing PARP inhibitors for prostate cancer. These companies conducted phase 3 trials looking at their respective PARP inhibitors in combination with ARPIs in the first-line mCRPC setting, and without selecting for patients with HRD disease. The goal was to increase the market potential of their products by moving PARP inhibitors earlier in the line of therapy and expanding their indications.

In February 2023, Cadence interviewed prostate cancer KOLs who were largely skeptical about using PARP inhibitors + ARPI in unselected patients. They pointed out that the BRCA-mutated population drove most of the clinical benefit. They also raised concerns about the cost and toxicity of the combination, the relevance of radiographic progression-free survival (rPFS) as a primary endpoint in the absence of overall survival data, and the availability of ARPI-naïve patients for this combination as ARPI use is increasing in the mCSPC landscape.

Fast forward a few months, and the KOLs’ predictions proved accurate. The US FDA’s Oncology Drug Advisory Committee (ODAC) voted to restrict the use of olaparib + abiraterone only for patients with BRCA-mutated tumors. Subsequently, the FDA approved olaparib (AstraZeneca and MSD’s Lynparza) in combination with abiraterone and prednisone or prednisone for the treatment of adult patients with deleterious or suspected deleterious BRCA-mutated mCRPC. Pfizer’s talazoparib was also approved for treating patients with homologous recombination repair (HRR) gene-mutated mCRPC.

Because of these critical KOL insights, our report predicted the FDA’s decision and provided valuable advance information about the potential uptake of these combinations. Marketers and forecasters who read the report learned that uptake of the PARPi + ARPI combination would be limited due to cost, toxicity, lack of overall survival data, and increased use of ARPIs earlier in treatment.

This example underscores the predictive power of Cadence’s KOL Market Snapshot Reports. By tapping into the expertise of leading physicians, these reports provide a forward-looking perspective that can help pharmaceutical executives from medical affairs, marketing, or market research make informed decisions.

Stay ahead of the curve. Gain insights into future developments. Understand the potential implications of clinical and regulatory changes. All this and more is possible with Cadence’s KOL Market Snapshot Reports.

To learn more about the series and to purchase the Prostate Cancer report, visit


Author Sugata Biswas

Sugata co-founded Cadence Communications & Research, a healthcare focused agency offering medical communications and marketing research services, in 2008 with Laura Smith. Sugata currently heads the market research group at firm and has spearheaded key strategic initiatives, leveraging his deep technical expertise and industry insights to drive business growth. Sugata also served roles in consulting and market research at Andersen Consulting (now Accenture), The Wilkerson Group, Amgen, and ICI. In addition to his corporate pursuits, Sugata has made substantial contributions to the academic realm. He co-authored "Management Consulting: A Complete Guide to the Industry" with Daryl Twitchell (1st ed. 1999, 2nd ed. 2002, Wiley). Sugata regularly shares his expertise through speaking engagements, addressing key topics like healthcare trends, marketing research, and management consulting. Sugata received his BA in Economics (with honors) from The University of Chicago, an MA in Economics from Utah State University, and an MBA from Yale University. Sugata may be contacted at

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