EMBRACA: Results of talazoparib vs chemotherapy relative to prior CT in patients with advanced breast cancer

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Published: 12 Jun 2019
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Dr Johannes Ettl - Technical University, Munich, Germany

Dr Johannes Ettl speaks to ecancer at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting about the EMBRACA trial.

He explains that the trial looked at outcomes of the PARP inhibitor talazoparib versus chemotherapy to treat patients with advanced breast cancer and a germline BRCA mutation who had received chemotherapy prior to taking part in the trial.

Dr Ettl reports that they found there was a benefit to using talazoparib in terms of reponse rate, duration of response, progression free survival - regardless of how many chemotherapy lines the patient had received prior to the trial.

He concludes that it is important to note that while talazoparib is effective and consistently tolerable in all lines of treatment, it is most effective when given early in treatment.

We presented an abstract concerning the patients in the EMBRACA trial. EMBRACA was the registration trial for the PARP inhibitor talazoparib and what we did is we investigated the effectiveness, the outcome, of the patients relative to the prior chemotherapy lines the patients had before they entered the trials.

We found out that irrespective of the line of chemotherapies which were given before patients entered the trial that talazoparib did benefit the patients. There was an effectiveness in terms of response rate, duration of response, PFS, irrespective of whether they had one line of chemotherapy before or two or even more than two lines. That basically was the result.

One conclusion, as I said, is that you can give talazoparib in first line, second line or third line, in all the lines people will benefit but it is also very important that in the first line therapy it is the most effective therapy line. So it’s to be given early, that’s probably the best thing to do. The other thing is that in all these situations it was superior to chemotherapy, so this is an important message. Another message is also that toxicity did not differ between the lines so it’s not an agent which gets more problematic in terms of safety or toxicity the further on you get in therapy.

Were there any adverse events at all?

There are adverse events with talazoparib, with PARP inhibition. It’s mainly haematological AEs like bone marrow suppression, anaemia, neutropenia and thrombocytopenia, that’s the main side effects we experience with talazoparib.

I think it has an impact because talazoparib is registered for therapy of metastatic BRCA patients but it is registered for several different lines of therapy. So the impact on standard of care would be that we should try to give talazoparib in the early line because this is the most effective line, where it is most effective. On the other hand, if you do have patients who have not had PARP inhibitors but have already had one or two lines of chemotherapy it’s still safe to give it and it’s still effective.