A phase 2 study of pamiparib in the treatment of patients with locally advanced or metastatic HER2-negative breast cancer with germline BRCA mutation.

Authors

null

Tao Sun

Liaoning Cancer Hospital & Institute, Shenyang, China

Tao Sun , Yanxia Shi , Jiuwei Cui , Yongmei Yin , Quchang Ouyang , Qiang Liu , Qingyuan Zhang , Yiding Chen , Shao Zhimin , Shouman Wang , Xiaojia Wang , Zhongsheng Tong , Yahua Zhong , Min Yan , Xi Yan , Chuan Wang , Haiyuan Yang , Miao Li , Xiao Xiang , Binghe Xu

Organizations

Liaoning Cancer Hospital & Institute, Shenyang, China, Sun Yat-sen University Cancer Center, Guangzhou, China, The First Hospital of Jilin University, Changchun, China, Jiangsu Province Hospital, Nanjing, China, Hunan Cancer Hospital, Changsha, China, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Changchun, China, Harbin Medical University Cancer Hospital, Harbin, China, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China, Fudan University Shanghai Cancer Center, Shanghai, China, Xiangya Hospital, Central South University, Changsha, Hunan, China, Zheijang Cancer Hospital, Hangzhou, China, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China, Zhongnan Hospital of Wuhan University, Wuhan, China, Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China, West China Hospital of Sichuan University, Chengdu, China, Fujian Medical University Union Hospital, Fujian, China, BeiGene Ltd., Beijing, China, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China

Research Funding

Pharmaceutical/Biotech Company
This trial is sponsored by BeiGene, Ltd. Medical writing support, under the direction of the authors, was provided by Yasmin Issop, PhD, and Shannon Galgani, MSci, of Ashfield Medcomms, an Ashfield Health company, and was funded by BeiGene, Ltd

Background: Breast cancer is the most common cancer among women, with up to 37% of patients (pts) harboring germline BRCA1/2 mutations (gBRCA1/2m) that appear to be sensitive to poly (ADP-ribose) polymerase proteins 1 and 2 (PARP1/2) inhibition. Pamiparib is an orally administered selective PARP1/2 inhibitor that has the potential to cross the blood-brain barrier. This study evaluated the efficacy and safety of pamiparib in pts with locally advanced/metastatic human epidermal growth factor receptor 2-negative (HER2-) breast cancer, with deleterious or suspected deleterious gBRCA1/2m, who received ≤ 2 prior lines of chemotherapy. Methods: In this open-label, phase 2, multi-center study in China (NCT03575065), pts with locally advanced/metastatic HER2- breast cancer with deleterious or suspected deleterious gBRCA1/2m triple negative breast cancer (TNBC cohort) or hormone receptor-positive (HR+)/HER2- breast cancer (HR+ cohort) were enrolled. Pts received pamiparib 60 mg orally twice daily in 28-day cycles. The primary endpoint was objective response rate (ORR; RECIST v1.1) by independent review committee (IRC). Secondary endpoints included duration of response (DOR) and progression free survival (PFS) by IRC, overall survival (OS), safety and tolerability. Results: 88 pts were enrolled (median age 45.5 years), 76 pts (TNBC cohort n = 55; HR+ cohort n = 21) had measurable disease at baseline per IRC. 60 pts (68.2%) received 1 or 2 prior lines of chemotherapy; 42 pts (47.7%) were treated with platinum previously. Median follow-up was 13.77 months (TNBC cohort, 10.87 months; HR+ cohort, 18.45 months). In the TNBC cohort: confirmed ORR was 38.2% (95% CI: 25.4–52.3); median DOR (mDOR) was 6.97 months (95% CI: 3.94–not estimable[NE]); median PFS (mPFS) was 5.49 months (95% CI: 3.65–7.33); median OS (mOS) was 17.08 months (95% CI:13.70–NE). In the HR+ cohort: confirmed ORR was 61.9% (95% CI: 38.4–81.9); mDOR was 7.49 months (95% CI: 5.55–14.75); mPFS was 9.20 months (95% CI: 7.39–11.93); mOS was not reached (NR; 95% CI 18.10–NE). ≥ Grade 3 treatment emergent adverse events (TEAEs) occurred in 54 pts (61.4%); anemia was the most common TEAE, occurring in 77 pts (87.5%). Dose reduction due to TEAEs occurred for 57 pts (64.8%); discontinuations due to TEAEs occurred for 2 pts (2.3%). Conclusions: Pamiparib showed a promising response in pts with locally advanced/metastatic HER2- breast cancer with a gBRCA1/2m. The safety profile of pamiparib was considered acceptable and was generally consistent with therapies in the same class. Clinical trial information: NCT03575065.

Efficacy by cohort.


TNBC

(N = 62)
HR(+)/HER2(-)

(N = 26)
Efficacy Evaluable Analysis Set, N
55
21
ORR by IRC, n (% [95% CI])
21 (38.2% [25.4–52.3])
13 (61.9% [38.4–81.9])
mDOR by IRC, months (95% CI)
6.97 (3.94–NE)
7.49 (5.55–14.75)
mPFS by IRC, months (95% CI)
5.49 (3.65–7.33)
9.20 (7.39–11.93)
mOS, months (95% CI)
17.08 (13.70–NE)
NR (18.10–NE)

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

Other Breast Cancer Subtypes

Clinical Trial Registration Number

NCT03575065

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 1087)

DOI

10.1200/JCO.2021.39.15_suppl.1087

Abstract #

1087

Poster Bd #

Online Only

Abstract Disclosures