Talazoparib (TALA), an oral poly (ADP-ribose) polymerase (PARP) inhibitor for men with metastatic castration-resistant prostate cancer (mCRPC) and DNA damage response (DDR) alterations: Detailed safety analyses from TALAPRO-1 trial.

Authors

Niven Mehra

Niven Mehra

Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands

Niven Mehra , Karim Fizazi , Johann S. De Bono , Philippe Barthélémy , Tanya B. Dorff , Adam Patrick Stirling , Jean-Pascal H. Machiels , Davide Bimbatti , Deepak Kilari , Herlinde Dumez , Consuelo Buttigliero , Inge M. van Oort , Elena Castro , Hsiang-Chun Chen , Nicola Di Santo , Liza L DeAnnuntis , Cynthia G. Healy , Giorgio V. Scagliotti

Organizations

Department of Medical Oncology, Radboud University Medical Center, Nijmegen, Netherlands, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France, The Institute of Cancer Research and Royal Marsden Hospital, London, United Kingdom, Medical Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France, City of Hope Comprehensive Cancer Center, Duarte, CA, ICON Cancer Centre, Queensland, Australia, Cliniques Universitaires Saint-Luc, Brussels, Belgium, and Université Catholique de Louvain, Louvain-La-Neuve, Belgium, Medical Oncology 1 Unit, Department of Oncology, Istituto Oncologico Veneto IOV IRCCS, Padua, Italy, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, and Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy, Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain, Pfizer Inc., La Jolla, CA, Pfizer Inc., Durham, NC, Pfizer Inc., Collegeville, PA

Research Funding

Pharmaceutical/Biotech Company
Pfizer

Background: PARP inhibitors have recently been approved for the treatment of mCRPC. In this Phase 2 study, we explore the safety profile of TALA in men with mCRPC with the aim of understanding how patients (pts) with adverse events (AEs) were managed during the trial. Methods: TALAPRO-1 (NCT03148795) is a single-arm, open-label, phase 2 study of TALA in pts with progressive mCRPC, measurable soft tissue disease, and DDRm likely to sensitize to PARPi (ATM, ATR, BRCA1/2, CHEK2, FANCA, MLH1, MRE11A, NBN, PALB2, RAD51C), who received ≥1 taxane-based chemotherapy and progressed on ≥1 novel hormonal therapy (enzalutamide/abiraterone). The primary objective was confirmed objective response by central independent review; the assessment of safety included AEs, incidence of dose modifications and of permanent treatment discontinuation due to AEs, and clinical laboratory tests. Results: In the TALA-treated population (1 mg/daily; n=127), 95.3% (121/127) experienced all-causality AEs. The most common (≥15%) hematologic AEs were anemia (any grade, 48.8%; G3, 30.7% [no G4 events]), thrombocytopenia (all grade, 18.9%; G3/4, 8.7%), and neutropenia (all grade, 16.5%, G3, 7.9% [no G4]). Median time from first dose of TALA to onset of first episode of G≥3 anemia, neutropenia, and thrombocytopenia was 56, 48, and 17 days, respectively. G3 anemia lasted a median of 7 days, G3 neutropenia lasted a median of 12 days, G3 and G4 thrombocytopenia lasted a median of 8 and 11 days, respectively. Hematologic AEs typically occurred during the first 4–5 months of TALA treatment and were managed by dose modifications and supportive care. 34.6% of pts received a blood transfusion product, and most transfusions occurred when hemoglobin was between 7.0–10.0 g/dL. Overlapping G3/4 hematologic AEs were infrequent on TALA (anemia + neutropenia 4.7%; anemia + thrombocytopenia 5.5%; neutropenia + thrombocytopenia 1.6%). In pts who had anemia, 12.6% also had fatigue; in those with thrombocytopenia, 4.7% had a subsequent bleeding event; in those with neutropenia, 1.6% had an overlapping infection. The most common non-hematologic AEs (≥15%) were nausea (any grade, 33.1%; G3/4, 2.4%), decreased appetite (any grade, 28.3%; G3/4, 3.1%), and asthenia/fatigue (any grade, 23.6%/19.7%; G3/4, 3.9%/1.6%). In the treated population, dose reduction of TALA due to all-causality AE occurred in 33 pts (26.0%). Treatment discontinuation due to all-causality AEs was low and occurred in 15 pts (11.8%); the most frequent (≥2 pts) AEs leading to discontinuation of TALA were back pain and platelet count decrease (each, 1.6% [2/127 pts]). There were no treatment-related deaths. Conclusions: A manageable safety profile and durable antitumor effects were observed with TALA in men with heavily pretreated mCRPC in this phase 2 study. Clinical trial information: NCT03148795

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Genitourinary Cancer—Prostate, Testicular, and Penile

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Prostate Cancer– Advanced/Castrate-Resistant

Clinical Trial Registration Number

NCT03148795

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 5047)

DOI

10.1200/JCO.2021.39.15_suppl.5047

Abstract #

5047

Poster Bd #

Online Only

Abstract Disclosures