Dr. Rugo on Takeaways From the IMpassion130 Trial in TNBC

Hope S. Rugo, MD, a professor in the Department of Medicine, Hematology/Oncology, and director, Breast Oncology and Clinical Trials Education, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discusses takeaways from the phase 3 IMpassion130 trial in metastatic triple-negative breast cancer (TNBC).

On March 8, 2019, the FDA granted an accelerated approval to the combination of atezolizumab (Tecentriq) and nab-paclitaxel (Abraxane) for the frontline treatment of patients with unresectable locally advanced or metastatic PD-L1–positive TNBC. The approval is based on findings from the phase 3 IMpassion130 trial, in which the combination led to a 40% reduction in the risk of disease progression or death compared with nab-paclitaxel alone in this patient population.

The trial revealed that not all patients with metastatic TNBC will respond to a checkpoint inhibitor, says Rugo. Additionally, determining the optimal chemotherapy partner to use with atezolizumab requires additional research.

IMpassion130 also highlighted that understanding how to best manage immune-related toxicities such as adrenal insufficiency is critical in TNBC, explains Rugo.

The role of checkpoint inhibitors in combination with other chemotherapy backbones is being investigated in patients with metastatic TNBC who relapse within a 6- to 12-month time period, says Rugo. Additional clinical trials are looking at atezolizumab and pembrolizumab (Keytruda) for patients who have an early relapse.