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Study: Research on the PARP inhibitor talazoparib (Talzenna) for early-stage breast cancer is promising

The PARP inhibitor talazoparib (Talzenna) has been useful for treatment of advanced or metastatic breast cancer for patients with BRCA mutations. A preliminary study showed that the majority of patients who took talazoparib alone before surgery for early-stage breast cancer had effective treatment and manageable side effects. Expanded clinical trials are in progress to verify this result. (10/4/19)

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Contents

At a glance                  In-depth                                
Findings               Limitations                
Clinical trials Resources
Questions for your doctor  


STUDY AT A GLANCE

This study is about:

Whether the Talzenna () is effective for treating patients with cancer that can be surgically removed in patients with inherited  mutations.

Why is this study important?

Treating breast cancer before surgery (also known as therapy) is used to reduce the size of the tumor and the risk of cancer recurrence. PARP inhibitors are a type of that has been approved for treating breast cancer in people with BRCA mutations. This study is one of the first to test whether a PARP inhibitor used alone (without chemotherapy) before surgery is effective for treatment of early-stage breast cancer.

Study findings: 

This pilot study included 20 patients. The goal was to test the effectiveness and side effects of (talazoparib) alone when taken for 6 months before surgery in patients with I, II or III breast cancer who had a hereditary BRCA mutation.

The majority of patients treated with talazoparib (Talzenna) before surgery had a pathologic complete response [pCR]), meaning that they had no detectable cancer in their breast or at the time of surgery. The study measured residual cancer burden (RCB), the amount of tumor that remains after treatment.

  • 10 of 19 (53%) patients had a pathologic complete response (pCR) and had no remaining cancer burden after treatment.
  • 12 of 19 (63%) of participants had no or low remaining cancer burden.
     
  • The majority of participants with either triple-negative or breast cancer had no or low remaining cancer burden.
     
  • 53% of participants with mutations had low or no residual tumor.
  • 100% of participants with mutations had low or no residual tumor.
     
  • Patients with several rare types of breast cancer had pathologic complete response.

The side effects observed were tolerable tor most patients.

  • The most common milder side effects were nausea, fatigue, anemia (low red blood cells), hair loss, dizziness and breathing difficulties.
     
  • The most common severe side effects were anemia and nausea.

What does this mean for me?

Two PARP inhibitors are approved in the U.S. to treat advanced breast and several others for ovarian cancer. As of now, no PARP inhibitors have been approved for early-stage breast cancer. Ongoing clinical trials are looking at the effectiveness and safety of these drugs for people in this population.

More research on talazoparib (Talzenna) as a treatment for early-stage breast cancer is needed to determine if this initial study result can be confirmed.

If you have metastatic breast cancer and have a BRCA mutation, you might consider discussing PARP inhibitor treatment with your health care provider.

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Posted 10/4/19
 

References

Litton JK, Scoggins ME, Hess , et al. "Neoadjuvant Talazoparib for patients with operable breast cancer with a BRCA pathogenic variant." Journal of Clinical Oncology. Published online Aug 28, 2019. DOI: https://doi.org/10.1200/JCO.19.01304.
 

Disclosure

FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

Expert Guidelines

National Comprehensive Cancer Network guidelines regarding who should undergo genetic counseling and testing recommend speaking with a genetics expert about genetic testing if you have been diagnosed with breast cancer and any of the following apply to you:     

  • You have a blood relative who has tested positive for an inherited mutation 
  • You have any of the following:  
    • Breast cancer at age 50 or younger. 
    • Male breast cancer at any age.
    • Ovarian cancer at any age. 
    • Triple-negative breast cancer at any age.
    • Two separate breast cancer diagnoses.
    • Eastern European Jewish ancestry and breast cancer at any age.
    • Lobular breast cancer and a family history of diffuse gastric cancer.
    • breast cancer and are at high-risk for recurrence.
    • Tumor testing shows a mutation in a gene that is associated with .

OR 

  • You have one or more close family members who have had:  
    • Young-onset or rare cancers.
    • Breast cancer at age 50 or younger.
    • Triple-negative breast cancer.
    • Male breast cancer, ovarian cancer, pancreatic cancer or metastatic  cancer at any age.
    • Two separate cancer diagnoses.
    • Metastatic prostate cancer or prostate cancer that is high-risk or very-high-risk. 

The American Society of Breast Cancer Surgeons (ASBrS) released guidelines in 2019 recommending that all women diagnosed with breast cancer have access to genetic testing for inherited mutations in breast cancer genes. 

If you are uncertain whether you meet the guidelines above and you are interested in or considering genetic testing, you should speak with a cancer genetics expert

Updated: 07/28/2023

Expert Guidelines

National Comprehensive Cancer Network (NCCN) guidelines address treating early-onset breast cancer in people with an inherited BRCA1 or BRCA2 mutation. For people who are at high risk for recurrence, the NCCN recommends considering a year of with olaparib after chemotherapy is completed.  

Updated: 06/06/2022

Questions To Ask Your Doctor

  • What type of treatment is best for me prior to my breast cancer surgery?
  • Am I eligible for any clinical trials of PARP inhibitors for early-stage breast cancer?
  • I have metastatic breast cancer; what are the benefits and risks of PARP inhibitor treatment for me?

Peer Support

The following organizations offer peer support services for people with or at high risk for breast cancer:

Updated: 05/07/2024

Who covered this study?

Healio

Also published in:

Med News Today

Neoadjuvant talazoparib induces pathologic complete response in BRCA-mutated operable breast cancer This article rates 3.5 out of 5 stars

The Oncology Learning Network

Talazoparib Yields Significant Pathologic Complete Response in gBRCA-Positive, Operable Breast Cancer This article rates 2.5 out of 5 stars

How we rated the media