ESMO 2024 – no hiding Truqap’s triple-negative flop
AstraZeneca’s underwhelming AKT inhibitor Truqap had a rare breakthrough with approval in a subset of ER-positive breast cancer patients, but no attempt has been made to gloss over the failure of its pivotal CAPItello-290 trial, in front-line triple-negative breast cancer. That’s despite any hope ESMO might have raised by accepting CAPItello-290 data as a late-breaker. UT Southwestern Medical Center’s Professor Heather McArthur on Friday revealed OS numbers, confirming Astra’s earlier statement that there was no benefit for Truqap plus chemo either in the overall population or in patients with tumours harbouring PIK3CA/AKT1/PTEN alterations; the latter group provided the way into ER-positive breast cancer for Truqap. Moreover, a forest plot showed no subgroup of CAPItello-290 patients in whom Truqap might have raised a positive survival signal. Interestingly PFS did yield a numerical benefit versus chemo, both in PIK3CA/AKT1/PTEN-altered tumours (HR=0.70) and in all-comers (HR=0.72). Any signal here is clearly not worth pursuing, with McArthur calling CAPItello-290 a failed study.
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