Breast cancer (invasive) · line 2 · Talazoparib monotherapy (gBRCA-mutant HER2- locally advanced or metastatic breast)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Line of therapy | 2 |
|---|---|
| Track | standard |
| Linked regimen | REG-TALAZOPARIB-MONO-BREAST |
| ID | IND-BREAST-BRCA-MET-TALAZOPARIB |
|---|---|
| Type | Indication |
| Status | reviewed 2026-04-29 | pending_clinical_signoff |
| Diseases | DIS-BREAST |
| Sources | SRC-EMBRACA-LITTON-2018 SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Notes
EMBRACA (NCT01945775): Phase III, gBRCA1/2-mutant HER2- locally advanced or metastatic breast cancer (≤3 prior cytotoxic regimens for advanced disease). Talazoparib 1 mg PO daily vs physician's- choice single-agent chemo. Median PFS 8.6 vs 5.6 mo (HR 0.54); ORR 62.6% vs 27.2%. OS not significantly different at final analysis (HR 0.85, p=0.17). FDA approval Oct 2018. This indication is the HR+/HER2- BRCA-mut variant; TNBC variant is IND-BREAST-TNBC -2L-BRCA-TALAZOPARIB. Olaparib OlympiAD (PFS 7.0 vs 4.2 mo, HR 0.58) is overlapping option; selection driven by AE profile — talazoparib has higher anemia / transfusion burden (~39% G≥3 vs ~16% with olaparib) but greater PARP-trapping potency. Pre-start: germline BRCA1/2 panel (peripheral blood) confirmed pathogenic/likely-pathogenic. UA access: talazoparib registered; NSZU does not cover for breast — out-of-pocket.
Used By
Algorithms
ALGO-BREAST-HR-POS-2L- ALGO-BREAST-HR-POS-2L
Handbook Chapters
HB-BREAST-HER2-POS-MET-1L- HER2+ metastatic breast cancer: first-line reasoningHB-BREAST-HR-POS-HER2-NEG-1L- HR+/HER2- metastatic breast cancer: first-line reasoning
Handbook Questions
HQ-BREAST-HR-POS-1L-003- HQ-BREAST-HR-POS-1L-003