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
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) | 68.7 | 33.3 |
(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 (%) | ||
Anemia | 49 (49.5) | 11 (25.6) |
Neutropenia | 22 (22.2) | 13 (30.2) |
Thrombocytopenia | 19 (19.2) | 3 (7.0) |
Any grade nonhematologic AEs, n % | ||
Fatigue | 59 (59.6) | 21 (48.8) |
Nausea | 47 (47.5) | 22 (51.2) |
Alopecia | 34 (34.3) | 10 (23.3) |
Headache | 32 (32.3) | 11 (25.6) |
Treatment discontinuation, n/N*, (%) | 6/99 (6.1) | 6/43 (14.0) |
*Safety population
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