Evidence map›Paper›PMID 41980055›Full record

ArticleCancer2026

A phase 1 study of ASTX727 plus talazoparib in patients with triple-negative or hormone resistant/HER2-negative metastatic breast cancer.

Kathy D Miller, Alexandra Thomas, Sandra Althouse, Yong Zang, Erin Conder, Ryan Burgos, Bryan P Schneider, Tarah Ballinger, Emily Douglas, Katherine Ansley and 5 more

Abstract readClinical Trial, Phase I
In one paragraph

Article in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Kathy D MillerIndiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0002-7125-883X
Alexandra ThomasDuke Cancer Institute, Duke University, Durham, North Carolina, USA.ORCID https://orcid.org/0000-0001-9022-2229
Sandra AlthouseBiostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Yong ZangBiostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Erin ConderIndiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
Ryan BurgosVan Andel Institute, Grand Rapids, Michigan, USA.ORCID https://orcid.org/0000-0002-3683-6286
Bryan P SchneiderIndiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
Tarah BallingerIndiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.ORCID https://orcid.org/0000-0002-6797-2758
Emily DouglasWake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Katherine AnsleyWake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
H Josh JangVan Andel Institute, Grand Rapids, Michigan, USA.
Woonbok ChungCoriell Institute for Medical Research, Camden, New Jersey, USA.
Jean-Pierre IssaCoriell Institute for Medical Research, Camden, New Jersey, USA.
Kenneth P NephewIndiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.
Feyruz V RassoolUniversity of Maryland School of Medicine, Baltimore, Maryland, USA.

Funding

Astex PharmaceuticalsBreast Cancer Research FoundationPfizerStand Up To Cancer
6 · The paper itself

Abstract

backgroundPoly(adenosine diphosphate ribose) polymerase (PARP) is recruited to DNA damage sites along with epigenetic factors such as DNA methyltransferase 1 (DNMT1). Inhibitors of DNMT modulate reactive oxygen species (ROS)-cyclic adenosine monophosphate (cAMP)/Protein Kinase A signaling and induce a "BRCAness phenotype" that further sensitizes cells to PARPi. In preclinical studies, combined DNMTi + PARPi therapy was effective in both triple-negative (TNBC) and hormone resistant (HRBC) models with intact BRCA.

methodsThe authors conducted a phase 1 study combining the oral DNMTi ASTX727 with the PARPi talazoparib in patients with previously treated TNBC or HRBC. Patients with deleterious mutations of BRCA were excluded. A classical 3+3 design guided dose escalation/de-escalation, and 28 days constituted each cycle. Serial peripheral blood mononuclear cells (PBMCs) were analyzed for changes in methylation using the Infinium Methylation EPIC BeadChip and LINE1 sequencing.

resultsThirty-four evaluable patients were enrolled and treated in eight dose cohorts. Myelosuppression was common with grade >3 neutropenia in 42% and grade 3 anemia and thrombocytopenia in 13%. Dose-limiting toxicity was limited to neutropenia. Efficacy was assessed in 29 patients. There were no objective responses, six patients had stable disease persisting for >4 months in three patients. LINE1 demethylation ranged from ∼2%-10% and immune-specific CpGs (methylation in immune cells) changed 1%-5% at day 15. Methylation changes were not dose-dependent.

conclusionsASTX727 plus talazoparib produces significant myelosuppression without other adverse events. Modest methylation changes in PBMCs were detected. There were no objective responses, but some heavily pretreated patients had stable disease for >4 months despite the attenuated doses.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsPhthalazinesTriple Negative Breast NeoplasmsAdultAgedDecitabineDNA MethylationDrug CombinationsDrug Resistance, NeoplasmErb-b2 Receptor Tyrosine KinasesFemaleHumansMiddle AgedPoly(ADP-ribose) Polymerase InhibitorsDecitabinedecitabine and cedazuridine drug combinationDrug CombinationsErb-b2 Receptor Tyrosine KinasesPhthalazinesPoly(ADP-ribose) Polymerase Inhibitorstalazoparibbreast cancerDNA methyltransferase Iepigenetichomologous recombination DNA repairinflammasomePARP inhibitorphase 1 clinical trial

Identifiers

PMID41980055
PMCPMC13078666

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.