Opinion
Video
Neeraj Agarwal, MD, outlines data on enzalutamide plus talazoparib in mCRPC
Author(s):
"A 14-month delay in disease progression is a very meaningful end point to our patients, because that basically means delay in symptoms, delay in fractures, [and] delay in pain in the castration-resistance setting," says Neeraj Agarwal, MD, FASCO.
Final data from the phase 3 TALAPRO-2 trial (NCT03395197) showed that the combination of enzalutamide (Xtandi) plus talazoparib (Talzenna) led to a statistically significant and clinically meaningful improvement in overall survival vs enzalutamide alone in patients with metastatic castration-resistant prostate cancer (mCRPC).1
These data were recently presented at the 2025 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium in San Francisco, California.
In an interview with Urology Times®, Neeraj Agarwal, MD, FASCO, of the Huntsman Cancer Institute of the University of Utah in Salt Lake City, recapped these findings in the context of the current state of care for patients with mCRPC. Currently, he explains, the overall survival (OS) for these patients in the US is less than 3 years, and many patients progress quickly. This makes the need for new treatment options critical.
Initial data from the TALAPRO-2 trial were shared in 2023, showing that the combination of enzalutamide plus talazoparib extended radiographic progression-free survival (rPFS) vs enzalutamide alone. In the updated report, the median rPFS was 33.1 months with enzalutamide plus talazoparib vs 19.5 months with enzalutamide alone, translating to a 33% reduction in the risk of progression or death with the combination (HR, 0.667; 95% CI, 0.551–0.807; P< .0001).
On this data point, Agarwal noted, “A 14-month delay in disease progression is a very meaningful end point to our patients, because that basically means delay in symptoms, delay in fractures, [and] delay in pain in the castration-resistance setting.”
Additionally, data showed that the combination also significantly extended OS. Median OS was 45.8 months with the combination compared with 37.0 months with enzalutamide alone (HR, 0.796; 95% CI, 0.661–0.958;P= .0155).
Benefits were seen across all subgroups assessed.
REFERENCES
1. Agarwal N, Azad A, Carles J, et al. Final overall survival (OS) with talazoparib (TALA) + enzalutamide (ENZA) as first-line treatment in unselected patients with metastatic castration-resistant prostate cancer (mCRPC) in the phase 3 TALAPRO-2 trial. J Clin Oncol. 43, 2025 (suppl 5; abstr LBA18). doi:10.1200/JCO.2025.43.5_suppl.LBA18
