Talazoparib + enzalutamide linked to improved survival for patients with mCRPC unselected for HRR gene alterations
WEDNESDAY, Feb. 19, 2025 (HealthDay News) — For patients with metastatic castration-resistant prostate cancer (mCRPC) unselected for homologous recombination repair (HRR) gene alterations, talazoparib (TALA) + enzalutamide (ENZA) is associated with improved overall survival versus placebo + ENZA, according to a study presented at the American Society of Clinical Oncology annual Genitourinary Cancers Symposium, held from Feb. 13 to 15 in San Francisco.
Neeraj Agarwal, M.D., from the Huntsman Cancer Institute at the University of Utah in Salt Lake City, and colleagues reported final overall survival (OS) data among patients with mCRPC unselected for HRR gene alterations who had improved radiographic progression-free survival with TALA + ENZA versus placebo + ENZA as first-line treatment in the phase 3 TALAPRO-2 trial.
A total of 805 patients were randomly assigned: 402 and 403 to TALA + ENZA and placebo + ENZA, respectively. At the data cutoff (Sept. 3, 2024), 52 and 60 percent of patients in the TALA + ENZA and placebo + ENZA arms, respectively, had died. The researchers found that the hazard ratio for OS was 0.796 (95 percent confidence interval, 0.661 to 0.958) for TALA + ENZA versus placebo + ENZA, with a median OS of 45.8 and 37.0 months, respectively. In patients who were HRR-deficient and in those who were HRR-nondeficient/unknown, OS favored TALA + ENZA versus placebo + ENZA (hazard ratios, 0.549 [95 percent confidence interval, 0.364 to 0.826] and 0.878 [95 percent confidence interval, 0.713 to 1.080], respectively). Updated radiographic progression-free survival data favored TALA + ENZA versus placebo + ENZA, consistent with the primary analysis (hazard ratio, 0.667; 95 percent confidence interval, 0.551 to 0.807).
“TALA + ENZA demonstrated a statistically significant and clinically meaningful improvement in OS versus standard-of-care ENZA,” the authors write.
Several authors disclosed ties to Pfizer, which manufactures talazoparib.
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