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
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 Disclosures
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