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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2279 - EMBRACA: Comparison of efficacy and safety of talazoparib (TALA) and physician's choice of therapy (PCT) in patients (pts) with advanced breast cancer (aBC), a germline BRCA1/2 mutation (gBRCAm), and prior platinum treatment

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Topics

Targeted Therapy;  Genetic and Genomic Testing, Counseling

Tumour Site

Breast Cancer

Presenters

Miguel Martín

Citation

Annals of Oncology (2018) 29 (suppl_8): viii90-viii121. 10.1093/annonc/mdy272

Authors

M. Martín1, W. Eiermann2, H.S. Rugo3, J. Ettl4, S.A. Hurvitz5, A. Gonçalves6, R. Yerushalmi7, D. Markova8, I.C. Tudor8, J.L. Blum9, A.L. Hannah10, J.K. Litton11

Author affiliations

  • 1 Medical Oncology, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, 28029 - Madrid/ES
  • 2 Chest Surgery, Interdisziplinäres Onkologisches Zentrum München, München/DE
  • 3 Breast Cancer Center, UCSF Helen Diller Family Comprehensive Cancer Center, 94115 - San Francisco/US
  • 4 Obstetrics And Gynecology, Klinikum rechts der Isar, Technische Universität München, 80333 - Munich/DE
  • 5 Hematology/oncology, University of California, Los Angeles, 90404 - Santa Monica/US
  • 6 Medical Oncology, Institut Paoli-Calmettes, 13274 - Marseille/FR
  • 7 Medical Oncology, Rabin Medical Center, Beilinson Hospital, 49100 - Petah Tikva/IL
  • 8 Biostatistics, Pfizer, Inc., San Francisco/US
  • 9 Medical Oncology, Baylor Sammons Cancer Center, Texas Oncology, US Oncology, Dallas/US
  • 10 Medical Oncology, Pfizer, Inc., San Francisco/US
  • 11 Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 77030 - Houston/US
More

Resources

Abstract 2279

Background

TALA is a dual-mechanism PARP inhibitor that prevents DNA damage repair by trapping PARP on DNA, resulting in cell death in BRCA1/2-mutated cells.

Methods

EMBRACA is an open-label, randomised, 2-arm phase 3 trial in which efficacy and safety of TALA (1 mg/day) is compared with standard single-agent PCT (capecitabine, eribulin, gemcitabine, or vinorelbine) in pts with aBC and gBRCAm. In this analysis clinical outcomes were assessed in 2 subgroups of pts who had either received prior platinum (PP) or had no prior platinum (NPP) treatment.

Results

Of 431 pts randomised, 76 had PP in any setting (46 TALA; 30 PCT) and 355 were NPP (241 TALA; 114 PCT). Mean (SD) age was 46.4 (11.15) years. Pts in all groups had received a median of 1 prior cytotoxic regimen for aBC. TALA demonstrated a statistically significant improvement in both objective response rate (odds ratio [OR] [95% CI]: PP 3.16 [0.88-15.67], P=.0456; NPP 5.36 [2.89-9.89], P<.0001) and progression-free survival (hazard ratio [95% CI]: PP 0.76 [0.40-1.45], P=.41; NPP 0.52 [0.39-0.71], P<.0001) compared with PCT. Mean (SD) duration of TALA therapy was 7.2 (6.52) mo (PP) and 8.7 (7.09) mo (NPP), with 15% (PP) and 19% (NPP) of pts receiving TALA for ≥12 mo. Median duration of response (DOR) to TALA was longest in NPP pts (5.4 mo), followed by PP pts (4.2 mo); pts receiving PCT had a DOR of approximately 3.0 mo regardless of prior platinum status. Pts on TALA achieved a clinical benefit rate at 24 weeks (PP 59%; NPP 71%) with OR significantly favouring TALA over PCT in both groups. Of pts receiving TALA, nausea was the most common adverse event (AE) in PP pts (59%) and anaemia in NPP pts (53%). Serious AEs occurred in both PP (33%) and NPP pts (32%) taking TALA.

Conclusions

In pts with advanced gBRCAm breast cancer, TALA demonstrated statistically significant improvements in clinical outcomes for both PP and NPP subgroups compared with PCT. Although TALA treatment benefitted both groups, the benefit was greater if TALA was used before platinum therapy.

Clinical trial identification

NCT01945775.

Legal entity responsible for the study

Pfizer, Inc.

Funding

This study was sponsored by Medivation LLC, a Pfizer company.

Editorial Acknowledgement

Editorial and medical writing support funded by Pfizer Inc. were provided by Edwin Thrower, PhD, Mary Kacillas and Paula Stuckart of Ashfield Healthcare Communications, Middletown, Connecticut.

Disclosure

M. Martín: Consulting fees: Pfizer; Fees for non-CME services received directly from commercial interests or their agents: Pfizer. H.S. Rugo: Fees for contracted research to the University of California: Eisai, Genentech, GSK, Lilly, Macrogenics, Merck, Novartis, OBI Pharma, Pfizer, Plexxikon; Travel: Lilly, Mylan, Puma. J. Ettl: Consulting fees: Novartis, Pfizer, Roche, Eisai; Contracted research: Celgene; Honoraria: Pfizer, Roche, Teva, and Pierre Fabre. S.A. Hurvitz: Contracted research: Amgen, Bayer, BioMarin, BI, Cascadian Therapeutics, Dignitana, Genentech/Roche, GSK, Lilly, Medivation, Merrimack, Novartis, OBI Pharma, Pfizer, Puma Biotechnology, Sanofi; Travel: Bayer, Lilly, Novartis, and OBI Pharma. D. Markova, I.C. Tudor: Employee: Pfizer, Inc. J.L. Blum: Consulting fees: Pfizer. A.L. Hannah: Consulting fees: Basilea, Medivation/Pfizerand Nektar; Ownership interest: NeoGenomics Laboratories. J.K. Litton: Institutional-contracted research: Pfizer, Novartis, EMD-Serono, AstraZeneca, GlaxoSmithKline, Genentech; Advisory board participation: AstraZeneca and Pfizer, both uncompensated. All other authors have declared no conflicts of interest.

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