How Does Talazoparib Compare With Chemotherapy for Breast Cancer Subgroup?
Posted: Friday, September 21, 2018
Progression-free survival rates were better with talazoparib than with standard single-agent chemotherapy in patients with advanced breast cancer and a germline BRCA1/2 mutation, according to phase III study results published in The New England Journal of Medicine. In addition, Jennifer K. Litton, MD, of The University of Texas M.D. Anderson Cancer Center, Houston, and colleagues noted that “improvements in patient-reported outcomes indicated that talazoparib had a good side-effect profile.”
In the open-label EMBRACA trial, patients from 16 nations were randomized 2:1 to receive the PARP inhibitor talazoparib (n = 287; 1 mg once daily) or physician’s choice (capecitabine, eribulin, gemcitabine, or vinorelbine in 21-day cycles; n = 144). Progression-free survival, the primary endpoint, was assessed by blinded independent central review, and the median duration of follow-up was 11.2 months.
The mean progression-free survival in the talazoparib group was 8.6 months, versus 5.6 months in the standard-therapy group (P < .001). Hazard ratios favored talazoparib in each analyzed subgroup: patients with zero, one, and at least two previous cytotoxic regimens; those with triple-negative disease; patients with hormone receptor–positive disease; those with or without a history of central nervous system metastases; and patients with mutation in BRCA1 or BRCA2.
More grade 3 or 4 hematologic adverse events were reported with talazoparib than with standard therapy (55% vs. 38%), with the most common being anemia and neutropenia. However, more nonhematologic grade 3 adverse events were observed with standard therapy than with talazoparib (38% vs. 32%). “Treatment-associated myelotoxicity was managed by dose modifications or delays,” noted Dr. Litton and her team.
