Cited by 77PARP inhibition in cancer therapyBreast Cancer Treatment StudiesAdvanced Breast Cancer Therapies

TOPACIO/Keynote-162: Niraparib + pembrolizumab in patients (pts) with metastatic triple-negative breast cancer (TNBC), a phase 2 trial.

Vinayak, Shaveta, Tolaney, Sara M., Schwartzberg, Lee Steven, Mita, Monica M., McCann, Georgia Anne-Lee, Tan, Antoinette R., Wahner Hendrickson, Andrea Elisabeth, Forero-Torres, Andres +12 more·2018·Journal of Clinical Oncology

Abstract

1011 Background: Chemotherapy is a standard of care for TNBC despite its suboptimal efficacy. ≈15–20% of TNBC have BRCA1/2 mutations (mut); ≈75% of BRCA1 mut BCs are TN. Single agent poly(ADP-ribose) polymerase (PARP) inhibitors have clinical activity in pts with BRCA1/2 mutations (BRCAmut) BC and provide median PFS of 6 mos in pts with BRCAmut TNBC vs 3.5 mos for chemotherapy. Single-agent pembrolizumab (pembro), a programmed death 1(PD–1) inhibitor, has shown objective response rates (ORR) of 5–18% in previously treated TNBC. TOPACIO (NCT02657889) is a fully enrolled study evaluating the safety and efficacy of combination treatment with selective PARP1/2 inhibitor niraparib + pembro in pts with met TNBC. Methods: Pts received niraparib 200 mg orally once daily + pembro 200 mg IV on day 1 of each 21-day cycle. Primary efficacy endpoint was ORR and secondary endpoints included disease control rate (DCR = CR+PR+SD [stable disease]). Results: As of Jan 2018, 12 of 54 enrolled TNBC pts (22%) had deleterious BRCAmut; 9 (17%) not tested/indeterminate results. Median age was 54 yrs, with median of 1 prior line of therapy in the met setting (range 0–3); 22 (41%) had received prior platinum in the met setting; 39 (72%) had received prior (neo)adjuvant therapy. Forty-five pts were evaluable, with ≥1 on-study scan. To date, ORR is 29% and DCR is 49%, including 3 CR (7%), 10 PR (22%), 9 SD (20%), and 23 progressive disease (PD) (51%). Ten of 13 responders have ongoing responses; 13 pts have received > 6 mos of treatment (6 BRCAmut, 5 BRCAwt, 2 BRCAunk); 11 pts remain on treatment. The 12 BRCAmut pts were 1 CR, 7 PR, 1 SD and 3 PD. Median PFS in BRCAmut group is 8.1 mos (95% CI 0.2–NE). ORR (any BRCA status) was 33% in PD-L1-pos (combined proportion score ≥1%) vs 15% in PD-L1-neg pts. Treatment-related grade ≥3 AEs occurred in 27 pts (50%); most common were thrombocytopenia (13%) & anemia (11%). Follow-up is ongoing. Conclusions: Preliminary activity is encouraging with durable responses observed irrespective of BRCA1/2 or PD-L1 status or prior platinum exposure with the highest ORR in BRCAmut pts. No new safety signals were identified with the combination. Clinical trial information: NCT02657889. ORR DCR TNBC overall, n = 45 29% 49% TNBC BRCAmut, n = 12 67% 75%

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Crossref · 10.1200/jco.2018.36.15_suppl.1011

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  • Accumulating evidence indicates that PARPi plus α-PD-1/PD-L1 is a promising combination strategy in multiple types of cancers, including metastatic castrate-resistant prostate cancer and metastatic TNBC.

    “Accumulating evidence indicates that PARPi plus α-PD-1/PD-L1 is a promising combination strategy in multiple types of cancers, including metastatic castrate-resistant prostate cancer and metastatic TNBC [230, 231].”

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Authors
Vinayak, S., Tolaney, S. M., Schwartzberg, L. S., Mita, M. M., McCann, G. A.-L., Tan, A. R., Wahner Hendrickson, A. E., Forero-Torres, A., Anders, C. K., Wulf, G. M., Dillon, P. M., Lynce, F., Zarwan, C., Erban, J. K., Dezube, B. J., Zhou, Y., Buerstatte, N., Arora, S., Achour, H., & Telli, M. L.
Affiliations
  • Case Comprehensive Cancer Center (US)
  • Dana-Farber Cancer Institute (US)
  • The West Clinic, Memphis, TN;
  • Cedars-Sinai Medical Center (US)
  • The University of Texas at San Antonio Health Science Center (US)
  • Levine Cancer Institute (US)
  • Mayo Clinic Rochester, Rochester, MN;
  • University of Alabama at Birmingham, Birmingham, AL;
  • University of North Carolina at Chapel Hill (US)
  • Beth Israel Deaconess Medical Center (US)
  • University of Virginia (US)
  • MedStar Georgetown University Hospital (US)
  • Lahey Hospital and Medical Center (US)
  • Tufts Medical Center (US)
  • Tesaro (United States) (US)
  • Stanford University (US)
Venue
Journal of Clinical Oncology
Published
2018-05-20
Volume
36
Issue
15_suppl
Pages
1011-1011
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2807543909
Cited by
77
References
0
Citations by year
2025: 1 · 2024: 7 · 2023: 2 · 2022: 11 · 2021: 14 · 2020: 14 · 2019: 23 · 2018: 5
Type
conference abstract
Language
en
Open access
closed
Locations
Journal of Clinical Oncology (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › PARP inhibition in cancer therapy
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Advanced Breast Cancer Therapies
Keywords
niraparib, pembrolizumab, metastatic triple-negative breast cancer, PARP inhibitors, PD-1 inhibitors, BRCA mutations, combination immunotherapy, objective response rate, disease control rate, platinum-refractory disease, safety and tolerability, immune-related adverse events, PD-L1

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