Analysis of germline BRCA1/2 mutated (gBRCAmut) hormone receptor-positive (HR+) and triple negative breast cancer (TNBC) treated with talazoparib (TALA).

Authors

null

Wolfgang Eiermann

Interdisziplinäres Onkologisches Zentrum München, München, Germany

Wolfgang Eiermann , Hope S. Rugo , Sami Diab , Johannes Ettl , Sara A. Hurvitz , Anthony Goncalves , Kyung-Hun Lee , Louis Fehrenbacher , Rinat Yerushalmi , Lida A. Mina , Miguel Martin , Henri Hubert Roche , Young-Hyuck Im , Denka Markova , Iulia Cristina Tudor , Joanne Lorraine Blum , Alison L. Hannah , Jennifer Keating Litton

Organizations

Interdisziplinäres Onkologisches Zentrum München, München, Germany, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, University of Colorado Cancer Center, Aurora, CO, Department of Obstetrics and Gynecology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany, University of California, Los Angeles, Los Angeles, CA, Institut Paoli-Calmettes, Marseille, France, Seoul National University Hospital, Seoul, Korea, Republic of (South), Kaiser Permanente Northern California, Vallejo, CA, Rabin Medical Center, Beilinson Hospital, Petah Tikva, CA, Israel, Banner Health, Phoenix, AZ, Instituto de Investigación Sanitaria Gregorio Marañón, Ciberonc, Geicam, Universidad Complutense, Madrid, Spain, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse, Toulouse, France, Samsung Medical Center, Seoul, Korea, Republic of (South), Pfizer, Inc., San Francisco, CA, Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas, TX, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Pharmaceutical/Biotech Company

Background: TALA is a dual-mechanism PARP inhibitor that traps PARP on DNA in BRCA1/2-mutated cells, preventing DNA damage repair and causing cell death. Methods: EMBRACA (NCT01945775) is a randomized phase 3 trial comparing TALA (1 mg/day) with physician’s choice of therapy (PCT) (capecitabine, eribulin, gemcitabine, vinorelbine) in patients (pts) with gBRCAmut advanced breast cancer (aBC). Pts had HR+ BC or TNBC (HER2+ BC pts were excluded). An analysis was conducted to determine if TALA had different efficacy and safety based on receptor expression. Results: Of 431 pts randomized, 241 had HR+ BC and 190 had TNBC. TNBC pts had a lower median age compared to HR+ pts (43 vs 50 years); only HR+ pts included males (n = 7). More TNBC pts had received prior platinum therapy (26% vs 11% HR+); both groups had received a median of 1 prior cytotoxic regimen for aBC. Duration of TALA therapy was longer for pts with HR+ compared to TNBC (7.3 vs 5.4 months); 19% of both TNBC and HR+ pts received 12+ months of TALA. The hazard ratio for PFS was similar between the 2 groups, but the median estimates for TALA were different: 0.596 (0.406, 0.874) for TNBC pts, with mPFS of 5.8 months; 0.474 (0.318, 0.708) for HR+ pts, with mPFS of 9.4 months. ORR for TALA was similar for the 2 groups: 61.8% for TNBC vs 63.2% for HR+. Duration of response median for TALA was longer for HR+ (6.8 months) compared to TNBC (4.3 months); both groups included a subset with a prolonged response to TALA (28% HR+ and 17% TNBC had a continued response at 12 months; no PCT patient had a continued response at 12 months). The majority of both HR+ and TNBC TALA pts achieved a CBR24 (74.5% vs 61.5%). The primary toxicity for both groups was hematologic: for HR+ and TNBC, grade 3+ anemia (38.5% vs 40.0%), neutropenia (16.7% vs 26.2%), and thrombocytopenia (12.8% vs 16.9%). Drug-related grade 3+ nonhematologic toxicities were rare in both groups. Serious AEs were similar (30.8% HR+ vs 33.1% TNBC). Few pts experienced an AE that resulted in permanent discontinuation (5.8% HR+ vs 6.2% TNBC). Conclusions: Talazoparib demonstrated improved PFS and ORR in pts both with gBRCAmut HR+ BC and TNBC. The safety profile in these 2 groups was similar. Clinical trial information: NCT01945775

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

Other Breast Cancer Subtypes

Clinical Trial Registration Number

NCT01945775

Citation

J Clin Oncol 36, 2018 (suppl; abstr 1070)

DOI

10.1200/JCO.2018.36.15_suppl.1070

Abstract #

1070

Poster Bd #

151

Abstract Disclosures