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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Thursday, March 2, 2023
For patients with metastatic castration-resistant prostate carcinoma, the addition of the PARP inhibitor talazoparib to the standard androgen receptor inhibitor enzalutamide led to improved imaging-based progression-free survival, according to a presentation of the TALAPARO-2 trial findings during the 2023 American Society of Clinical Oncology (ASCO) Genitourinary (GU) Cancers Symposium (Abstract LBA17). This combination therapy was effective regardless of homologous recombination repair (HRR) status, according to Neeraj Agarwal, MD, FASCO, of the Huntsman Cancer Institute at the University of Utah, Salt Lake City, and colleagues.
“Results from the primary analysis of the TALAPARO-2 trial support the use of talazoparib plus enzalutamide as a first-line treatment for men with metastatic castration-resistant prostate carcinoma,” commented Dr. Agarwal during the presentation of the data.
A total of 805 patients with metastatic castration-resistant prostate carcinoma were recruited for the study. Patients were stratified based on their cancer treatment history with abiraterone or docetaxel and their HRR status. All patients were randomly assigned to receive combination treatment with talazoparib plus enzalutamide (n = 402) or enzalutamide plus a placebo (n = 403).
The study authors reported an improved imaging-based progression-free survival in patients treated with talazoparib plus enzalutamide regardless of HRR status. Talazoparib plus enzalutamide treatment led to a 37% decrease in patients’ risk of disease progression or death (hazard ratio [HR] = 0.63). A 27.9-month median radiographic progression-free survival was observed in patients with HRR-deficient metastatic castration-resistant prostate carcinoma (HR = 0.46). For patients without HRR-deficient disease, the median radiographic progression–free survival has yet to be reached. Moreover, the most common treatment-related adverse events experienced by patients treated with talazoparib plus enzalutamide included thrombocytopenia, anemia, and neutropenia, which ultimately led to the discontinuation of talazoparib in 19.1% of patients.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
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