Dr. Jhaveri Discusses the Potential of Immunotherapy in TNBC

Komal Jhaveri, MD, medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the potential for immunotherapy in the treatment of patients with triple-negative breast cancer (TNBC) based on results from the IMpassion130 trial.

Unlike in other solid tumors such as melanoma, lung cancer, and renal cell carcinoma, TNBC has not seen as much positive data with immunotherapy, explains Jhaveri. However, exciting data presented at the 2018 ESMO Congress suggest that immunotherapy may play a critical role in the treatment of certain patients.

In the phase III randomized IMpassion130 trial, patients with treatment-naïve metastatic TNBC were randomized to receive either standard of care nab-paclitaxel (Abraxane) or atezolizumab (Tecentriq) in combination with nab-paclitaxel. The primary endpoint of the study was progression-free survival in the intent-to-treat (ITT) and the PD-L1—positive subgroups. Overall survival (OS) was a planned analysis with hierarchal testing for OS in both subgroups, says Jhaveri.

Results indicated a hazard ratio of 0.8, reflecting a 20% reduction in the risk of progression or death with the combination. Patients also experienced a 25-month median OS. Although patients in the PD-L1—positive subgroup experienced a clinical meaningful benefit in OS, investigators could not claim statistical significance due to the hierarchal testing of that group. That being said, a 25-month median OS in the first-line setting is unprecedented for this difficult-to-treat, aggressive subtype of breast cancer, she stressed.