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Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial

Open access
Litton, J.K., Hurvitz, S.A., Mina, L.A., Rugo, H.S., Lee, K.-H., Gonçalves, A., Diab, S., Woodward, N., Goodwin, A., Yerushalmi, R., Roché, H., Im, Y.-H., Eiermann, W., Quek, R.G.W., Usari, T., Lanzalone, S., Czibere, A., Blum, J.L., Martin, M., Ettl, J.·2020·Annals of Oncology

Abstract

BACKGROUND: In EMBRACA, talazoparib prolonged progression-free survival versus chemotherapy (hazard ratio [HR] 0.542 [95% confidence interval (CI) 0.413-0.711]; P < 0.0001) and improved patient-reported outcomes (PRO) in germline BRCA1/2 (gBRCA1/2)-mutated advanced breast cancer (ABC). We report final overall survival (OS). PATIENTS AND METHODS: This randomized phase III trial enrolled patients with gBRCA1/2-mutated HER2-negative ABC. Patients received talazoparib or physician's choice of chemotherapy. OS was analyzed using stratified HR and log-rank test and prespecified rank-preserving structural failure time model to account for subsequent treatments. RESULTS: A total of 431 patients were entered in a randomized study (287 talazoparib/144 chemotherapy) with 412 patients treated (286 talazoparib/126 chemotherapy). By 30 September 2019, 216 deaths (75.3%) occurred for talazoparib and 108 (75.0%) chemotherapy; median follow-up was 44.9 and 36.8 months, respectively. HR for OS with talazoparib versus chemotherapy was 0.848 (95% CI 0.670-1.073; P = 0.17); median (95% CI) 19.3 months (16.6-22.5 months) versus 19.5 months (17.4-22.4 months). Kaplan-Meier survival percentages (95% CI) for talazoparib versus chemotherapy: month 12, 71% (66% to 76%)/74% (66% to 81%); month 24, 42% (36% to 47%)/38% (30% to 47%); month 36, 27% (22% to 33%)/21% (14% to 29%). Most patients received subsequent treatments: for talazoparib and chemotherapy, 46.3%/41.7% received platinum and 4.5%/32.6% received a poly(ADP-ribose) polymerase (PARP) inhibitor, respectively. Adjusting for subsequent PARP and/or platinum use, HR for OS was 0.756 (95% bootstrap CI 0.503-1.029). Grade 3-4 adverse events occurred in 69.6% (talazoparib) and 64.3% (chemotherapy) patients, consistent with previous reports. Extended follow-up showed significant overall improvement and delay in time to definitive clinically meaningful deterioration in global health status/quality of life and breast symptoms favoring talazoparib versus chemotherapy (P < 0.01 for all), consistent with initial analyses. CONCLUSIONS: In gBRCA1/2-mutated HER2-negative ABC, talazoparib did not significantly improve OS over chemotherapy; subsequent treatments may have impacted analysis. Safety was consistent with previous observations. PRO continued to favor talazoparib.

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Authors
Litton, J. K., Hurvitz, S. A., Mina, L. A., Rugo, H. S., Lee, K.-H., Gonçalves, A., Diab, S., Woodward, N., Goodwin, A., Yerushalmi, R., Roché, H., Im, Y.-H., Eiermann, W., Quek, R. G. W., Usari, T., Lanzalone, S., Czibere, A., Blum, J. L., Martin, M., & Ettl, J.
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2020-11
Volume
31
Issue
11
Pages
1526-1535
ISSN
0923-7534 (ISSN-L)
OpenAlex
W3069915980
Cited by
412
References
15
FWCI
17.32
Type
journal article
Language
en
Open access
hybrid
Licence
Funders
Medivation

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CoChat. (2026). Citation check: Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial. https://app.cochat.ai/papers/10.1016/j.annonc.2020.08.2098
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Litton, J. K., Hurvitz, S. A., Mina, L. A., Rugo, H. S., Lee, K.-H., Gonçalves, A., Diab, S., Woodward, N., Goodwin, A., Yerushalmi, R., Roché, H., Im, Y.-H., Eiermann, W., Quek, R. G. W., Usari, T., Lanzalone, S., Czibere, A., Blum, J. L., Martin, M., & Ettl, J. (2020). Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial. Annals of Oncology. https://doi.org/10.1016/j.annonc.2020.08.2098

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.