TALAPRO-1: Phase II study of talazoparib (TALA) in patients (pts) with DNA damage repair alterations (DDRm) and metastatic castration-resistant prostate cancer (mCRPC).

Authors

null

Johann S. De Bono

The Royal Marsden NHS Foundation Trust, London, United Kingdom

Johann S. De Bono , Niven Mehra , Celestia S. Higano , Fred Saad , Consuelo Buttigliero , Inge M. van Oort , Marielena Mata , Hsiang-Chun Chen , Cynthia G. Healy , Akos Czibere , Karim Fizazi

Organizations

The Royal Marsden NHS Foundation Trust, London, United Kingdom, Department of Oncology, Radboud University Medical Center, Nijmegen, Netherlands, University of British Columbia, Vancouver, BC, Canada, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, QC, Canada, Department of Oncology, University of Turin, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy, Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands, Pfizer Inc., San Diego, CA, Pfizer Inc., Collegeville, PA, Pfizer Inc., Cambridge, MA, Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France

Research Funding

Other
Pfizer Inc

Background: Poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi) show antitumor activity in mCRPC/DDRm pts treated with novel hormonal therapy (NHT). TALAPRO-1 is an open-label study evaluating TALA (a potent PARP inhibitor/trapper) in men with mCRPC/DDRm. We report a planned interim analysis (IA; Dec 2019). Updated results at a Sep 4 2020 cut-off, available in November 2020, will be presented at the meeting. Methods: TALAPRO-1 (NCT03148795) is enrolling pts (N ≈ 100) with measurable soft tissue disease, progressive mCRPC, and DDRm likely to sensitize to PARPi (ATM, ATR, BRCA1/2, CHEK2, FANCA, MLH1, MRE11A, NBN, PALB2, RAD51C), who received 1–2 chemotherapy regimens (≥1 taxane-based) for metastatic disease and progressed on ≥1 NHT (enzalutamide/abiraterone acetate) given for mCRPC. DDRm are defined as known/likely pathogenic variants or homozygous deletions. Pts receive oral TALA 1 mg/day (moderate renal impairment 0.75 mg/day) until radiographic progression, unacceptable toxicity, consent withdrawal, or death. Primary endpoint is objective response rate (ORR). Secondary endpoints: time to objective response; response duration; prostate-specific antigen (PSA) decrease ≥50%; circulating tumor cell (CTC) count conversion (to CTC = 0 and <5 per 7.5 mL blood); time to PSA progression; radiographic progression-free survival (rPFS); overall survival; safety. A planned efficacy/safety IA was done when 60 pts with DDRm and measurable disease completed ≥6 months of TALA/no longer followed. Radiographic responses are based on investigator assessments. Results: 113 pts received TALA (cut-off Dec 12 2019); 75 pts were evaluable for IA, with DDRm, had measurable disease, received ≥16 weeks’ treatment, and were assessed for ORR (54.7% BRCA1/2, 4.0% PALB2, 22.7% ATM; 18.7% other DDRm).All pts evaluable for IA had prior docetaxel; 45.3% cabazitaxel. Confirmed ORR, rPFS, and composite response (investigator-assessed) in pts who received TALA for ≥16 weeks are in the table. Most common treatment-emergent adverse events: anemia (42.5%); nausea (32.7%). Conclusions: TALA monotherapy has encouraging antitumor activity in docetaxel-pretreated mCRPC pts with BRCA1/2 alterations and was generally well tolerated. Funding: Pfizer Inc. Clinical trial information: NCT03148795

BRCA1/2
N = 46
PALB2
N = 4
ATM
N = 18
Other
N = 18
Total
N = 86
a,bORR, %
(response/n)
43.9
(18/41)
33.3
(1/3)
11.8
(2/17)
028.0
(21/75)
brPFS, mo (95% CI)9.3 (8.1-13.7)7.4 (2-7.4)5.5 (1.7-8.2)3.7 (1.7-3.9)-
b,cComposite response, % (response/n)76.1
(35/46)
50.0
(2/4)
27.8
(5/18)
11.1
(2/18)
51.2
(44/86)

aMeasurable soft tissue disease per investigator assessment at screening; bDDR-deficient population; cObjective response and/or PSA response ≥50% and/or CTC conversion (from CTC ≥5 to <5).

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Abstract Details

Meeting

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Prostate Cancer - Advanced Disease

Track

Prostate Cancer - Advanced

Sub Track

Therapeutics

Clinical Trial Registration Number

NCT03148795

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 93)

DOI

10.1200/JCO.2021.39.6_suppl.93

Abstract #

93

Poster Bd #

Online Only

Abstract Disclosures