VJOncology is committed to improving our service to you

Share this video  

VJOncology is committed to improving our service to you

SABCS 2022 | The challenges of treating early-stage TNBC

Heather McArthur, MD, MPH, UT Southwestern Medical Center, Dallas, TX, talks on a clinical controversies session at the San Antonio Breast Cancer Symposium (SABCS) 2022 surrounding the challenges associated with treating early-stage triple-negative breast cancer (TNBC) and discusses the new standard-of-care established from the Phase III KEYNOTE-522 (NCT03036488) trial. KEYNOTE-522 had shown statistically significant and clinically meaningful pathological complete response (pCR) and event-free survival (EFS) rates in patients with early triple-negative breast cancer (TNBC) with the addition of pembrolizumab to neoadjuvant chemotherapy. This interview took place at the San Antonio Breast Cancer Symposium (SABCS) 2022 in San Antonio, TX.

These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.

Transcript (edited for clarity)

So they had a new session this year called Clinical Controversies, where we discussed, as a panel, various controversies that are facing us in the treatment of breast cancer. And the one that I was attending to was the challenge of treating patients with triple-negative breast cancer, early-stage disease, and the impact of KEYNOTE-522 becoming a standard of care and how we reconcile all the other data sets with the KEYNOTE-522 data...

So they had a new session this year called Clinical Controversies, where we discussed, as a panel, various controversies that are facing us in the treatment of breast cancer. And the one that I was attending to was the challenge of treating patients with triple-negative breast cancer, early-stage disease, and the impact of KEYNOTE-522 becoming a standard of care and how we reconcile all the other data sets with the KEYNOTE-522 data. So the KEYNOTE 5-22 study, just as a reminder, co-administration of pembrolizumab in the neoadjuvant setting with four different cytotoxic agents and then afterward in the adjuvant setting to complete a year.

And that became the standard of care based on a 3-year event-free survival advantage of 7.7%. So an almost 8% improvement in cure rate as early as three years. The challenge has been in understanding best practice, particularly for patients who do not achieve a pathologic complete response. So those patients seem to derive the most benefit from pembrolizumab access of more than 10%. But what wasn’t permitted on the KEYNOTE-522 experience was co-administration of other drugs that had been really standard of care, like capecitabine and olaparib. So we talked about the CREATE-X data, which led to the standard of care, adjuvant capecitabine administration and subsequent meta-analysis showing an overall-survival advantage, and talked about how we reconciled that with the pembrolizumab data.

We talked about the metastatic setting and how capecitabine and pembrolizumab had been co-administered in that setting without any unexpected safety signals. And so my practice has been to co-administer both drugs in that very high-risk population. And then Dr. Domchek talked about the OlympiA study that led to the standard of care, adjuvant olaparib, so PARP inhibitor administration for high-risk patients with germline BRCA associated tumors. We also have data from the metastatic setting showing that those drugs can be co-administered safely with pembrolizumab. And so that has been a practice that we’ve adopted in that setting.

Read more...

Sign-up for our Newsletter!

Keep up to date with all the latest news with our monthly newsletter