Talzenna (talazoparib) vs Phesgo (pertuzumab, trastuzumab, and hyaluronidase)

Talzenna (talazoparib) is a PARP inhibitor used specifically to treat certain patients with germline BRCA-mutated, HER2-negative locally advanced or metastatic breast cancer. Phesgo, on the other hand, is a combination of two monoclonal antibodies, pertuzumab and trastuzumab, plus hyaluronidase, and is used to treat HER2-positive breast cancer, often in an early stage or metastatic setting. The choice between Talzenna and Phesgo would largely depend on the patient's specific type of breast cancer, particularly the presence of a BRCA mutation and the HER2 status, which should be determined by a healthcare professional.

Difference between Talzenna and Phesgo

Metric	Talzenna (talazoparib)	Phesgo (pertuzumab, trastuzumab, and hyaluronidase)
Generic name	Talazoparib	Pertuzumab, Trastuzumab, and Hyaluronidase
Indications	Germline BRCA-mutated HER2-negative locally advanced or metastatic breast cancer	HER2-positive breast cancer (use in combination with chemotherapy or as a single agent after chemotherapy)
Mechanism of action	Poly (ADP-ribose) polymerase (PARP) inhibitor	Combination of HER2/neu receptor antagonist and recombinant human hyaluronidase enzyme
Brand names	Talzenna	Phesgo
Administrative route	Oral	Subcutaneous injection
Side effects	Anemia, neutropenia, thrombocytopenia, fatigue, nausea, headache, etc.	Diarrhea, alopecia, nausea, fatigue, neuropathy, etc.
Contraindications	Hypersensitivity to talazoparib	Hypersensitivity to active substances or excipients, severe dyspnea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy
Drug class	PARP inhibitor	Monoclonal antibodies and enzyme
Manufacturer	Pfizer	Genentech (Roche)

Efficacy

Talzenna (talazoparib) Efficacy in Breast Cancer

Talzenna (talazoparib) is a poly (ADP-ribose) polymerase (PARP) inhibitor used in the treatment of breast cancer. Specifically, it is indicated for patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative locally advanced or metastatic breast cancer. The efficacy of Talzenna was established in the EMBRACA trial, a randomized, open-label study comparing talazoparib to standard chemotherapy. Patients treated with Talzenna showed a significant improvement in progression-free survival (PFS) compared to those who received chemotherapy. This highlights Talzenna's role in delaying the progression of BRCA-related breast cancer, offering a targeted treatment option for this patient population.

Phesgo (pertuzumab, trastuzumab, and hyaluronidase) Efficacy in Breast Cancer

Phesgo is a combination of two monoclonal antibodies, pertuzumab and trastuzumab, with the enzyme hyaluronidase, used for the treatment of HER2-positive breast cancer. This subcutaneous injection is designed for use in combination with chemotherapy for the treatment of early breast cancer at high risk of recurrence, and in metastatic settings. The efficacy of Phesgo was demonstrated in the FeDeriCa study, which confirmed non-inferior levels of pertuzumab and trastuzumab in the blood compared to intravenous administration of the two drugs. This suggests that Phesgo can provide a similar clinical benefit with the added convenience of subcutaneous administration.

Both Talzenna and Phesgo represent significant advancements in the personalized treatment of breast cancer. Talzenna targets the genetic vulnerability associated with BRCA mutations, while Phesgo offers a more convenient administration route for HER2-targeted therapy without compromising efficacy. The development of these drugs underscores the importance of understanding the biological underpinnings of breast cancer to provide more effective and patient-friendly treatments.

In conclusion, the efficacy of Talzenna and Phesgo in the treatment of breast cancer has been substantiated through clinical trials, offering valuable options for patients with specific genetic and molecular profiles of the disease. As treatments evolve, these medications contribute to the expanding arsenal of targeted therapies aimed at improving outcomes and quality of life for breast cancer patients.

Regulatory Agency Approvals

Talzenna

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA
Therapeutic Goods Administration (TGA), Australia

Phesgo

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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