The goal of this clinical trial is to prove that the RECAP test is capable of selecting advanced breast cancer patients sensitive for treatment with the PARP inhibitor talazoparib. Participants will undergo an ultrasound-guided biopsy and a blood withdrawal. Homologous Recombination (HR) deficient patients (approximately 30%) can start talazoparib treatment until progression of the disease or unacceptable side-effects and their response will be evaluated.
This is a single arm, prospective multicenter study among patients with advanced breast cancer with RECAP-based HRD phenotype who will be treated with talazoparib, a strong PARP inhibitor. After signing informed consent, metastatic breast cancer patients will undergo an ultrasound (or CT-) guided biopsy in order to obtain at least two biopsies from a metastatic lesion to determine the HR status by the RECAP test and a blood withdrawal for ctDNA isolation. HR proficient (HRP) patients will receive anti-tumor therapy (non study drug) on discretion of their treating physician; only the response on treatment will be registered. Approximately 30% of screened patients will have an HRD tumor and thus will be eligible to start talazoparib monotherapy until PD or unacceptable side effects. The primary endpoint is PFS at four months. Additional endpoints will include overall response rate and overall survival. Upon progression, patients will be kindly asked for consent to perform another biopsy (optional) and blood withdrawal in order to prove reversibility of the RECAP test outcome (from HRD to HRP) and explore potential mechanisms of resistance (both in tissue and ctDNA).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
66
Talazoparib is administered daily as single agent, 1 mg orally until unacceptable toxicity or progression of disease.
Leiden University Medical Center
Leiden, South Holland, Netherlands
RECRUITINGErasmus Medical Center
Rotterdam, South Holland, Netherlands
RECRUITINGGroningen University Medical Center
Groningen, Netherlands
RECRUITINGProportion of patients with PFS at 4 months
The percentage of patients with advanced HRD breast cancer with PFS of 4 months or longer on talazoparib monotherapy. Disease assessment is performed by CT chest-abdomen per RECIST v 1.1.
Time frame: Baseline. During the intervention: every 2 cycles (each cycle is 28 days), preferably within 7 days before the start of every uneven cycle. Follow-up until PD, unacceptable toxicity or death. Until all patients have reached PFS endpoint (end of study).
Overall response rate (ORR)
The proportion of patients whose confirmed best overall response is either a PR or CR based upon investigator assessment per standard RECIST v1.1. Disease assessment is performed by CT chest-abdomen.
Time frame: Baseline. During the intervention: every 2 cycles (each cycle is 28 days), preferably within 7 days before the start of every uneven cycle. Follow-up until PD, unacceptable toxicity or death. Until all patients have reached PFS endpoint (end of study).
Overall survival (OS)
OS of patients with advanced HRD breast cancer treated with talazoparib
Time frame: Time from first administration of talazoparib to time of death due to any cause. Follow-up on survival at least every 3 months for year 1, every 6 months for year 2 and 3 and annually until death. Until all patients have reached PFS (end of study).
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.