A randomized phase II trial reports the clinical efficacy of poly(ADP-ribose) polymerase (PARP) inhibitor olaparib combined with abiraterone in metastatic castration-resistant prostate cancer. At a cut-off date in September 2017, median radiographic progression-free survival was significantly longer in the abiraterone plus olaparib group than in the abiraterone plus placebo group (13.8 versus 8.2 months; HR 0.65, 95% CI 0.44–0.97, P = 0.034). Regarding safety, patients receiving the combination therapy had more grade 3 or worse and serious adverse events than those in the placebo arm.