4.5 Article

Talazoparib versus Chemotherapy in Patients with HER2-Negative Advanced Breast Cancer and a Germline BRCA1/2 Mutation Enrolled in Asian Countries: Exploratory Subgroup Analysis of the Phase III EMBRACA Trial

Journal

CANCER RESEARCH AND TREATMENT
Volume 53, Issue 4, Pages 1084-1095

Publisher

KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2020.1381

Keywords

Key words Asian; Breast neoplasms; BRCA1; 2 mutation; HER2-negative; PARP inhibitor; Phase III; Talazoparib

Categories

Funding

  1. Pfizer
  2. Good Publication Practice (GPP3) guidelines
  3. Medivation

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In the phase III EMBRACA trial conducted in Asian regions, talazoparib showed numerically improved efficacy compared to chemotherapy in treating advanced breast cancer with fewer adverse events, making it a potentially promising treatment option for Asian patients.
Purpose We evaluated study outcomes in patients enrolled in Asian regions in the phase III EMBRACA trial of talazoparib vs. chemo Materials and Methods Patients with human epidermal growth factor receptor 2-negative germline BRCA1/2-mutated advanced breast cancer who received prior chemotherapy were randomized 2:1 to talazoparib 1 mg/day or chemotherapy (physician's choice). Primary endpoint was progression-free survival (PFS) per independent central review in the intent-to-treat (ITT) population. This posthoc analysis evaluated efficacy/safety endpoints in the ITT population of patients enrolled in Asian regions. Results Thirty-three patients were enrolled at Asian sites (talazoparib, n=23; chemotherapy, n=10). Baseline characteristics were generally comparable with the overall EMBRACA population. In Asian patients, median PFS was 9.0 months (95% confidence interval [CI], 3.0 to 15.2) for talazoparib and 7.1 months (95% CI, 1.2 to not reached) for chemotherapy (hazard ratio [HR], 0.74 [95% CI, 0.22 to 2.44]). Objective response rate was numerically higher for talazoparib vs. chemotherapy (62.5% [95% CI, 35.4 to 84.8] vs. 25.0% [95% CI, 3.2 to 65.1]). Median overall survival was 20.7 months (95% CI, 9.4 to 40.1) versus 21.2 months (95% CI, 2.7 to 35.0) (HR, 1.41 [95% CI, 0.49 to 4.05]). In Asian patients, fewer grade 3/4 adverse events (AEs), serious AEs (SAEs), grade 3/4 SAEs, and AEs resulting in dose reduction/discontinuation occurred with talazoparib than chemotherapy; for talazoparib, the frequency of these events was lower in Asian patients versus overall EMBRACA population. Conclusion In this subgroup analysis, talazoparib numerically improved efficacy versus chemotherapy and was generally well tolerated in Asian patients, with fewer grade 3/4 treatment-emergent AE (TEAEs), SAEs, and TEAEs leading to dose modification vs. the

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