Dr. Schmid on Activity With Neoadjuvant Pembrolizumab in TNBC

Peter Schmid, MD, PhD, lead at the Centre for Experimental Cancer Medicine, Barts Cancer Institute, discusses the benefit of pembrolizumab (Keytruda) when added to neoadjuvant chemotherapy in patients with triple-negative breast cancer (TNBC).

In KEYNOTE-522, the randomized, phase III trial randomized patients with either chemotherapy plus pembrolizumab or chemotherapy with placebo for 6 months before surgery. After surgery, patients were continually treated with pembrolizumab or placebo for 1 year.

The 2 endpoints of the trial were pathologic complete response (pCR) rate and event-free survival (EFS). Patients in the control arm had a pCR of 51.2% versus 64.8% in the pembrolizumab arm, with an absolute difference of 13.6% (95% CI, 5.4%-21.8%; P = .00055). This is a significant and meaningful difference, in which pCR can be seen as linked with positive long-term outcome and reduced risk of recurrence, concludes Schmid.