Talazoparib in Advanced Breast Cancer Patients With Homologous Recombinant Deficiency

  • STATUS
    Recruiting
  • End date
    May 10, 2025
  • participants needed
    70
  • sponsor
    Seoul National University Hospital
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Updated on 7 October 2022
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Summary

Talazoparib has shown clinical efficacy in breast cancer patients with germline BRCA1 or BRCA2 mutations. Beyond BRCA1 and BRCA2 mutations, it is plausible that talazoparib may have activity in patients with homologous recombination defects (HRD).

Description

BRCA 1/2 plays an essential role in homologous recombination repair and breast cancer patients with BRCA 1/2 germline mutation have homologous recombination defects (HRD). Besides BRCA1 or BRCA2 germline mutation, a proportion of breast cancer is characterized as having HRD through germline mutation, somatic mutation, and epigenetic alteration of other homologous recombination repair (HRR) genes (which includes but are not limited to ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, and RAD54L) (5). It is speculated that tumor with HRD may have clinical benefit from PARP inhibitor. However, the efficacy of talazoparib in advanced breast cancer with HRD is not known. The primary purpose of the present study is to evaluate the efficacy of talazoparib in breast cancer with HRD.

Details
Condition Advanced Breast Cancer
Treatment Talazoparib Oral Capsule
Clinical Study IdentifierNCT04892693
SponsorSeoul National University Hospital
Last Modified on7 October 2022

Eligibility

 Yes No Not Sure

Inclusion Criteria

Adults ≥19 years old
Pathologically documented breast cancer that is unresectable or metastatic
Tumor with homologous recombination deficiency (HRD) defined by
Germline or Somatic BRCA1/2 mutation
Homologous recombination repair (HRR) genes mutation
HRD detected through RAD51 foci formation functional assay
HRR genes: ATM, BARD1, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51C, RAD51D, and RAD54L
Previously treated with a taxane, unless this treatment was contraindicated (whether
Previous treatment with platinum therapy in the advanced or metastatic setting is permitted, provided the patient did not have a progression during the platinum treatment. If the patient was treated with neoadjuvant or adjuvant platinum therapy, at least 6 months of disease-free interval is required after the last dose
in recurrent/metastatic setting or in neoadjuvant/adjuvant setting)
Documented radiologic progression (during or after most recent treatment or within 6 months after completing adjuvant therapy)
If the patients had relapsed within 6 months after adjuvant therapy, this will be counted as a systemic chemotherapy for advanced or metastatic disease
At least 3 weeks has passed since last chemotherapy treatment
At least 2 weeks has passed since last hormone therapy or radiation therapy (including palliative radiation)
Eastern Cooperative Oncology Group (ECOG) performance status of 0, or 1
At least one measurable lesion that can be accurately assessed at baseline by computed tomography (CT) (magnetic resonance imaging [MRI] where CT is not feasible) and is suitable for repeated assessment as per RECIST v.1.1
Male and female subjects of reproductive/childbearing potential must agree to use a highly effective form of contraception or avoid intercourse during and upon completion of the study and for at least 7.0 months after the last dose of study treatment
This study recommend "Copper T intrauterine device" as a highly effective methods of contraception (<1% failure rate)
Adequate normal organ and marrow function measured within 28 days prior to
administration of study treatment
Hemoglobin ≥9.0 g/dL
Absolute neutrophil count (ANC) ≥ 1.5 x 109/L
Platelet count ≥ 75 x 109/L
Serum bilirubin ≤ 2.0mg/dL [This will not apply to patients with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of hemolysis or hepatic pathology), who will be allowed only in consultation with their physician.]
AST (SGOT)/ALT (SGPT) ≤2.5 x institutional upper limit of normal unless liver metastases are present, in which case it must be ≤5x ULN
Ability to understand and comply with protocol during study period
Adequate renal function: Serum creatinine ≤1.5mg/dL or estimated creatinine clearance >60 mL/min
Patients should sign a written informed consent before study entry
Negative urine pregnancy test within 7 days prior to registration in premenopausal
patients

Exclusion Criteria

Prior treatment PARP inhibitor
However, if the patient participated in a clinical trial evaluating adjuvant PARP inhibitor, patient is allowed to be included in the present study if the patient recurred 6 months after completing PARP inhibitor. No more than three line of previous systemic chemotherapy, excluding neo-adjuvant and adjuvant chemotherapy. (No limitation on hormone therapy. Hormone therapy is not counted as previous line)
If there is a standard treatment available for metastatic breast cancer
History of another primary malignancy except for
contralateral breast cancer
Adequately treated non-melanoma skin cancer or lentigo malignancy without evidence of disease
Malignancy treated with curative intent and with no known active disease ≥3 years
Adequately treated carcinoma in situ without evidence of disease
History of leptomeningeal carcinomatosis
Brain metastases or spinal cord compression
Patients with symptomatic uncontrolled brain metastases. A scan to confirm the absence of brain metastases is not required. The patient can receive a stable dose of corticosteroids before and during the study as long as these were started at least 4 weeks prior to treatment. Patients with spinal cord compression unless considered to have received definitive treatment for this and evidence of clinically stable disease for 28 days
Patients with GI tract disease resulting in an inability to take oral medication
malabsorption syndrome, a requirement for IV alimentation, prior surgical
Subjects with simple HBV carrier, a past or resolved HBV infection (defined as the presence of hepatitis B core antibody [anti-HBc] and absence of HBsAg) are eligible. Subjects positive for hepatitis C (HCV) antibody are eligible only if polymerase chain reaction is negative for HCV RNA
procedures affecting absorption, uncontrolled GI disease (e.g., Crohn's
disease, ulcerative colitis)
Female patients who are pregnant or breastfeeding
Judgment by the investigator that the patient is unsuitable to participate in the study and the patient is unlikely to comply with study procedures, restrictions and requirements
active infection or immunocompromised patients including tuberculosis (clinical
evaluation that includes clinical history, physical examination and
radiographic findings, and TB testing in line with local practice), hepatitis
B , hepatitis C, or human immunodeficiency virus (positive HIV 1/2
antibodies)
Patients who have a known immediate or delayed hypersensitivity reaction or
idiosyncrasy to drugs chemically related to any of the study agents or their
excipients
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