Grand Rounds
Timely Genetic Testing and Therapy Management in Patients With gBRCA-Mutated Metastatic Breast Cancer Receiving Talazoparib
Ashley Martinez,(1) DNP, APRN, FNP-BC, AOCNP®, CBCN, CPHQ, NEA-BC, Tiffany Jones,(2) MSN, ACNP-BC, Joanne C. Ryan,(3) PhD, RN, Chad M. Barnett,(3) PharmD, BCOP, Elpitha L. Soussou,(3) PharmD, MBA, and Sarah Donahue,(4) MPH, NP, AOCNP®
From (1)The University of Texas MD Anderson Cancer Center, Houston, Texas; (2)OHC/US Oncology Blue Ash, Cincinnati, Ohio; (3)Pfizer Inc., New York, New York; (4)University of California San Francisco
Authors’ disclosures of conflicts of interest are found at the end of this article.
Correspondence to: Joanne C. Ryan, PhD, RN, Pfizer Inc., 235 East 42nd Street, New York, NY 10017. E-mail: joanne.c.ryan@pfizer.com
J Adv Pract Oncol 2022;13(7):705–712 |
https://doi.org/10.6004/jadpro.2022.13.7.6 |
© 2022 Harborside™
ABSTRACT
Talazoparib is a poly(ADP-ribose) polymerase (PARP) inhibitor that has demonstrated strong efficacy with manageable side effects for patients with germline breast cancer susceptibility genes 1 or 2 (gBRCA1/2)-mutated, human epidermal growth factor receptor 2–negative, locally advanced or metastatic breast cancer (mBC) in the EMBRACA and ABRAZO trials. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Breast Cancer recommend genetic testing for all patients with recurrent or metastatic BC to identify those with a gBRCA1/2 mutation who would benefit from treatment with a PARP inhibitor. However, many patients who meet these criteria do not receive genetic testing for a variety of reasons. Advanced practitioners (APs) can play a key role in the care of these patients by guiding them through the genetic testing process and explaining how the results impact treatment choices. A hypothetical case study highlighting a 42-year-old woman who received a diagnosis of triple-negative mBC provides an example of genetic testing strategies, as well as management considerations, with the use of talazoparib that can be implemented by APs. The efficacy and safety of talazoparib are reviewed along with practical guidance on its use (i.e., managing adverse events and drug interactions) to optimize patient outcomes. The patient case described in this publication is fictional and does not represent actual events or a response from an actual patient. The authors developed this fictional case for educational purposes only.
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