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
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 | |
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a,bORR, % (response/n) | 43.9 (18/41) | 33.3 (1/3) | 11.8 (2/17) | 0 | 28.0 (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 Disclosures
2023 ASCO Annual Meeting
First Author: Karim Fizazi
2020 ASCO Virtual Scientific Program
First Author: Johann S. De Bono
2020 Genitourinary Cancers Symposium
First Author: Johann S. De Bono
2024 ASCO Genitourinary Cancers Symposium
First Author: Daniel Triner