Building momentum for subsets of patients with advanced triple-negative breast cancer
Mené dans 41 pays sur 902 patientes atteintes d'un cancer du sein triple négatif de stade localement avancé ou métastatique, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité de l'ajout de l'atézolizumab au nab-paclitaxel
Although additional treatment options are now emerging, for most patients chemotherapy remains the standard of care for the first-line treatment of metastatic triple-negative breast cancer. Encouraging results with drugs inhibiting PD-L1 and PD-1 in non-breast tumours with similar biology and the fact that PD-L1 expression is higher in triple-negative breast cancer than in other breast tumours led to several studies examining the efficacy of checkpoint inhibitors in metastatic triple-negative breast cancer. Studies using checkpoint inhibitor monotherapy have shown some efficacy in subsets of patients who have been less heavily pre-treated with chemotherapy, with evidence of immune cell infiltration, making data from combination strategies to reduce tumour burden and synergise with immune therapies highly anticipated. In 2018, results from the first positive phase 3 immunotherapy trial to show a significant progression-free survival benefit with atezolizumab in patients with metastatic and unresectable locally advanced triple-negative breast cancer, the IMpassion130 study, were reported, although the boundary for declaring a statistical advantage for the experimental group in the first interim analysis of overall survival was not crossed. The results led to approval of atezolizumab in this setting from both the US Food and Drug Administration and European Commission.
The Lancet Oncology , commentaire, 2018