4.7 Article

Talazoparib, a Poly(ADP-ribose) Polymerase Inhibitor, for Metastatic Castration-resistant Prostate Cancer and DNA Damage Response Alterations: TALAPRO-1 Safety Analyses

期刊

ONCOLOGIST
卷 27, 期 10, 页码 E783-E795

出版社

OXFORD UNIV PRESS
DOI: 10.1093/oncolo/oyac172

关键词

BRCA; castration-resistant prostatic cancer; PARP inhibitor; talazoparib

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资金

  1. Pfizer

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This study provides an in-depth analysis of the safety profile of talazoparib in men with metastatic castration-resistant prostate cancer. The most common adverse events include anemia, nausea, decreased appetite, and asthenia. Hematologic adverse events typically occur during the early months of treatment.
Background The phase II TALAPRO-1 study (NCT03148795) demonstrated durable antitumor activity in men with heavily pretreated metastatic castration-resistant prostate cancer (mCRPC). Here, we detail the safety profile of talazoparib. Patients and Methods Men received talazoparib 1 mg/day (moderate renal impairment 0.75 mg/day) orally until radiographic progression, unacceptable toxicity, investigator decision, consent withdrawal, or death. Adverse events (AEs) were evaluated: incidence, severity, timing, duration, potential overlap of selected AEs, dose modifications/discontinuations due to AEs, and new clinically significant changes in laboratory values and vital signs. Results In the safety population (N = 127; median age 69.0 years), 95.3% (121/127) experienced all-cause treatment-emergent adverse events (TEAEs). Most common were anemia (48.8% [62/127]), nausea (33.1% [42/127]), decreased appetite (28.3% [36/127]), and asthenia (23.6% [30/127]). Nonhematologic TEAEs were generally grades 1 and 2. No grade 5 TEAEs or deaths were treatment-related. Hematologic TEAEs typically occurred during the first 4-5 months of treatment. The median duration of grade 3-4 anemia, neutropenia, and thrombocytopenia was limited to 7-12 days. No grade 4 events of anemia or neutropenia occurred. Neither BRCA status nor alteration origin significantly impacted the safety profile. The median (range) treatment duration was 6.1 (0.4-24.9) months; treatment duration did not impact the incidence of anemia. Only 3 of the 15 (11.8% [15/127]) permanent treatment discontinuations were due to hematologic TEAEs (thrombocytopenia 1.6% [2/127]; leukopenia 0.8% [1/127]). Conclusion Common TEAEs associated with talazoparib could be managed through dose modifications/supportive care. Demonstrated efficacy and a manageable safety profile support continued evaluation of talazoparib in mCRPC. ClinicalTrials.gov identifier NCT03148795 To aid clinicians in the management of adverse events and to inform clinical trials investigating the use of talazoparib in combination with other anticancer treatments, this article provides an in-depth analysis of the safety profile of talazoparib in men with metastatic castration-resistant prostate cancer.

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