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Hello, my name is
Heather McArthur and
I'm the Clinical Director
of Breast Cancer and
Komen Distinguished
Chair of Clinical
Breast Cancer Research at
UT Southwestern in Dallas,
Texas and today we're
going to be talking about
post neoadjuvant therapy in
triple negative breast cancer.
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First, I'd like to
start out with a case,
this is a 38 year old woman
with a family history of
breast cancer who presents
with a palpable breast mass,
she undergoes mammography and
ultrasound which reveals a
3.2cm mass suspicious BIRADS-5,
so she undergoes a core
biopsy that reveals
a grade 3 invasive
ductal carcinoma
that's negative for
estrogen receptors,
progesterone
receptors, and HER2.
A breast MRI is
undertaken and confirms
the findings as outlined with
no additional
lesions identified.
0:55
This woman with stage two
triple negative breast
cancer would have
qualified for the KEYNOTE-522
study, as a reminder,
eligible women had
newly diagnosed
triple negative breast cancer by
central confirmation they had to
have T1c node positive
or greater than or
equal to T-2 disease,
they could be PD-L1 positive or
negative and there was a
stratification by T size,
nodal status, and platinum use.
Patients were
randomized to receive
neoadjuvant chemotherapy with or
without pembrolizumab, notably,
the neoadjuvant chemotherapy
that was administered
was weekly paclitaxel,
together with carboplatin,
which could be
administered either
every week or every three weeks,
followed by an anthracycline,
together with cyclophosphamide
every three weeks
for four cycles,
and patients received
concurrent placebo
or pembrolizumab.
For those patients assigned
to receive pembrolizumab,
they continued to
receive pembrolizumab in
the adjuvant setting
for nine cycles.
Almost 1,200 patients were
enrolled and there were
two co primary endpoints,
there was a primary end point
of pathologic complete response
and the second co-primary
endpoint of event free survival.
