Immunotherapy Offers New Hope in Triple Negative Breast Cancer
Results from the Impassion 130 clinical trial published in the New England Journal of Medicine have demonstrated that immunotherapy can improve survival in breast cancer, especially in anti-programmed cell death ligand 1 (PD-1+) patients. The results were seen with the PD-L1 drug Tecentriq used in combination with chemotherapy for the treatment of triple negative breast cancer.
The IMpassion130 clinical trial evaluated patients with metastatic or inoperable locally advanced triple negative breast cancer who had only had prior chemotherapy regimen in the curative setting. Over 900 women with triple negative breast cancer were treated with Tecentriq (atezolizumab) with or without chemotherapy as first-line therapy for at least six cycles in the absence of side effects and directly compared.
Overall 41% of the patients with triple negative breast cancer in the study were PD-L1+ which was defined as expression in greater than 1% on tumor-infiltrating immune cells.
Overall the addition of Tecentriq was reported to be associated with a 20% improvement in progression-free survival (PFS) and a 38% improvement in PD-L1+ cancers. The overall 1-year PFS rate was 24% with Tecentriq + chemotherapy versus 18% for chemotherapy alone. The difference in 1-year PFS rate between Tecentriq and placebo was also greater in PD-L1+ patients, at 29% versus 18%.
It’s clear that individuals with breast cancer can derive greater beneit from immunotherapy combined with chemotherapy. Women with breast cancer should undergo routine testing for PD-1 and other biomarkers. Determining the optimal chemotherapy backbone and immunotherapy combination will be the focus of ongoing and future clinical trials.
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