Talazoparib Maintenance Therapy in Triple-negative Breast Cancer

Inclusion Criteria

• •1. Histologically or cytologically confirmed TNBC patients receiving first- or second-line chemotherapy for recurrent, metastatic, or unresectable disease. The triple-negative breast cancer is defined as ER negative, PR negative, and HER2 negative receptor status
• •* ER and PR negative defined as IHC nuclear staining \< 1% AND
• •* HER2 negative defined as:
• •1. IHC 0, 1+ without ISH OR
• •2. IHC 2+ and ISH non-amplified (average HER2 gene copy number \< 4 signals/cell using single-probe ISH or HER2/CEP17 ratio \< 2.0 and average HER2 gene copy number \< 4 signals/cell in dual-probe ISH) OR
• •3. ISH non-amplified without IHC
• •2. Female patients with ≥19 years of age
• •3. Patients on first- or second-line platinum-based (cisplatin or carboplatin) chemotherapy regimen for recurrent, metastatic, or unresectable TNBC showing platinum-sensitivity during chemotherapy
• •* The platinum-based chemotherapy can be either monotherapy or combination doublet chemotherapy of carboplatin or cisplatin with following combination partners: Paclitaxel, Docetaxel, Gemcitabine, Eribulin, Vinorelbine, Capecitabine, and Nab-paclitaxel.
• •* For the patient who recurred within 12 months after the last dose of (neo)adjuvant chemotherapy for operable stage breast cancer, the (neo)adjuvant chemotherapy will be considered as one line of chemotherapy.
• •* The combined targeted therapy agents including bevacizumab will be allowed but should be discontinued before randomization.
• •The platinum sensitivity is determined as follows,
• •* Remaining stable disease after 6 tri-weekly doses or 18 weekly doses of platinum-based therapy (stable disease after 6 cycles)
• •* Remaining complete or partial response status after 4-6 tri-weekly doses or 12-18 weekly doses of platinum-based chemotherapy (partial or complete response after 4-6 cycles)
• •4. Patients who can receive germline BRCA1/2 mutation test or patients with previously known germline BRCA1/2 mutation status.
• •5. Provision of informed consent prior to any study specific procedures
• •6. Measurable disease and/or non-measurable or no evidence of disease assessed at baseline by CT as defined by RECIST 1.1
• •7. Patients who have received platinum as potentially curative treatment for a prior cancer (eg ovarian cancer) or as adjuvant/neoadjuvant treatment for breast cancer are eligible with at least 12 months elapsed between the last dose of curative platinum-based treatment and initiation of the platinum-based chemotherapy for recurrent, metastatic, or unresectable breast cancer.
• •8. ECOG performance status 0 or 1
• •9. Adequate organ function within 14 days before enrollment for treatment A. Absolute neutrophil count (ANC) ≥ 1500 cells/mm3 B. Platelets ≥ 100,000 cells/mm3 C. Hemoglobin ≥ 9.0g/dL with no blood transfusions (packed red blood cells) in the past 7 days D. Bilirubin ≤ 2.0 x ULN E. AST (SGOT) ≤ 3 x ULN (5.0 x ULN if hepatic metastases) F. ALT (SGPT) ≤ 3 x ULN (5.0 x ULN if hepatic metastases) G. Creatinine clearance ≥ 30mL/min as calculated using the Cockcroft-Gault equation or serum creatinine ≤ 1.5 ULN
• •10. 12-Lead electrocardiogram (ECG) with normal tracing or non-clinically significant changes that do not require medical intervention
• •11. QTc interval ≤470 msec and without history of Torsades de pointes
• •12. Not pregnant or nursing, fertile patients must use effective contraception 2 weeks before, during, and for 7 months after completion of study treatment
• •* A fertile female patient whose result of the urine test or serum pregnancy test was negative within 72 hours of the first dose. If the test results are positive or not-confirmatory negative, a serum pregnancy test should be performed.
• •* The fertile women are required to use proper contraception (inscribed in 11.13 section) during clinical trials and up to seven months after final administration, or agree to be surgically infertile or to stop having heterosexual sex.
• •The definition of infertile women is as follows, and the woman who do not fall under this category are judged to be fertile women.
• •* Women who have undergone infertility surgery (bilateral tubal resection, bilateral oophorectomy, or uterine resection)
• •* Women aged 55 or older who have no natural menstruation for more than 12 months before random assignment
• •* Women under the age of 55 with no natural menstruation and a menopause follicle hormone (FSH) concentration of 30 IU/L (or meet the standards of post-menopausal in the local lab) for a period of more than 12 months before randomization
• •13. No other concurrent severe and/or uncontrolled medical disease which could compromise study participation
• •14. Adequate treatment washout period before enrollment are below Treatment Washout Period Major surgery ≥ 4 weeks Radiation therapy ≥ 4 weeks (if palliative stereotactic radiation therapy ≥ 2 weeks)
• •15. For patients with Germline BRCA1/2 mutations, the patients whose use of PARP inhibitors outside this clinical trial after the treatment of the platinum chemotherapy is inappropriate, impossible, or difficult to implement due to the patient's rejection, judged by the investigator or the patient for various reasons (including economic reasons)