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Printable Handouts
Navigable Slide Index
- Introduction
- Case
- KEYNOTE-522
- KEYNOTE-522: pCR at IA1
- KEYNOTE-522: EFS update at IA4 (39.1mo)
- pCR by nodal status
- EFS by overall disease stage
- Overall survival
- Is all the IO benefit conferred with neoadjuvant administration?
- Studies which inform these decisions
- KEYNOTE-522: EFS by pCR
- EFS by pCR
- KEYNOTE-522: no pCR
- How do we reconcile with SOC capecitabine?
- A meta-analysis from 12 randomized trials including 15,457 patients
- First or second-line pembrolizumab with paclitaxel or capecitabine in mTNBC
- OlympiA trial design
- Patient demographics and disease characteristics
- Olaparib was superior
- Updated IDFS
- Second overall survival interim analysis – OS IA 2 (ITT)
- Other cancers?
- Quality of life
- Mediola: PARPi + PD-L1 antibody
- CREATE-X and OlympiA
- The current approach
- Acknowledgements
Topics Covered
- KEYNOTE-522
- Pembrolizumab
- Clinical trial results
- GeparNuevo
- Durvalumab
- SWOG 1418
- IMpassion030
- Pathologic complete response
- Capecitabine
- CREATE-X
- OlympiA
- Olaparib
- Mediola
- PARP inhibitors
Talk Citation
McArthur, H. (2023, October 31). Post-neoadjuvant therapy in triple-negative breast cancer (TNBC) [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved November 10, 2024, from https://doi.org/10.69645/AIQO3710.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Heather McArthur has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Oncology
Transcript
Please wait while the transcript is being prepared...
0:00
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.
0:19
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.