Efficacy and safety of talazoparib (TALA) or physician's choice of therapy (PCT) in United States patients (pts) with HER2- germline BRCA1/2-mutated (gBRCAm) locally advanced/metastatic breast cancer (LA/MBC) in the EMBRACA study.

Authors

null

Sami Diab

University of Colorado Cancer Center, Aurora, CO

Sami Diab , Hope S. Rugo , Lida A. Mina , Shannon Puhalla , Reshma L. Mahtani , Norah Lynn Henry , Neelima Denduluri , Denise A. Yardley , Yao Wang , Lillian Shahied Arruda , Iulia Cristina Tudor , Eric Roland Gauthier , Akos Gabor Czibere , Jennifer Keating Litton , Sara A. Hurvitz

Organizations

University of Colorado Cancer Center, Aurora, CO, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, Banner Health, Phoenix, AZ, University of Pittsburgh Medical Center Cancer Centers, Pittsburgh, PA, Sylvester Cancer Center, Deerfield Beach, FL, Huntsman Cancer Institute, Salt Lake City, UT, Virginia Cancer Specialists, Arlington, VA, Sarah Cannon Rsrch Inst, Nashville, TN, Pfizer Inc., New York, NY, Pfizer Inc, San Francisco, CA, Pfizer, Inc., San Francisco, CA, Pfizer, Inc., Cambridge, MA, The University of Texas MD Anderson Cancer Center, Houston, TX, University of California Los Angeles, Los Angeles, CA

Research Funding

Pharmaceutical/Biotech Company

Background: TALA is a poly(ADP-ribose) polymerase (PARP) inhibitor approved in the US for HER2- gBRCAm LA/MBC. Approval was based on results from the Phase 3 EMBRACA trial comparing efficacy/safety of TALA (1 mg/d) to PCT (capecitabine, eribulin, gemcitabine, vinorelbine) in HER2- gBRCAm LA/MBC pts. This analysis describes outcomes in US pts included in the pivotal study. Methods: Clinical findings from US pts enrolled in EMBRACA were analyzed. Pt characteristics, progression-free survival (PFS), objective response rate (ORR), clinical benefit rate (CBR), and safety/adverse events (AEs) were among the parameters assessed. Results: Of 431 randomized pts, 156 pts (36%) were from the US (TALA: 99; PCT: 57). Pt characteristics were balanced, although a higher percentage in the TALA arm had more poor prognostic features (eg, triple-negative breast cancer, disease-free interval < 12 mo, and more disease sites). TALA improved PFS, ORR, CBR, and duration of response (DOR) vs PCT (Table). 22% of pts in the TALA arm had a continued objective response at month 12 vs 0 pts in the PCT arm. The most common AEs in the TALA arm included anemia, neutropenia, thrombocytopenia, fatigue, nausea, alopecia, and headache; hematologic grade 3/4 AEs occurred more often than nonhematologic AEs. Conclusions: In US pts with HER2- gBRCAm LA/MBC, TALA demonstrated significant improvements in outcomes vs PCT with a manageable safety profile. Clinical trial information: NCT01945775

TALA
(n = 99)
PCT
(n = 57)
PFS, median, mo (95% CI)9.0 (7.0-12.9)5.8 (4.2-6.7)
HR (95% CI)0.5 (0.3-0.8)
ORR, n (%)51 (63.0)11 (24.4)
OR (95% CI)5.5 (2.4-16.1)
CBR, % (95% CI)68.733.3
(58.6-77.6)(21.4-47.1)
OR (95% CI)4.7 (2.2-10.6)
DOR, median, mo (95% CI)5.0 (4.1-6.4)3.1 (1.4-5.6)
HR (95% CI)0.4 (0.2-1.1)
Any grade hematologic AEs, n (%)
Anemia49 (49.5)11 (25.6)
Neutropenia22 (22.2)13 (30.2)
Thrombocytopenia19 (19.2)3 (7.0)
Any grade nonhematologic AEs, n %
Fatigue59 (59.6)21 (48.8)
Nausea47 (47.5)22 (51.2)
Alopecia34 (34.3)10 (23.3)
Headache32 (32.3)11 (25.6)
Treatment discontinuation, n/N*, (%)6/99 (6.1)6/43 (14.0)

*Safety population

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

Hormone Receptor-Positive

Clinical Trial Registration Number

NCT01945775

Citation

J Clin Oncol 37, 2019 (suppl; abstr 1044)

DOI

10.1200/JCO.2019.37.15_suppl.1044

Abstract #

1044

Poster Bd #

125

Abstract Disclosures