Dr. Sharma on Optimal Systemic Therapy for Early-Stage TNBC

Priyanka Sharma, MD, professor of Medicine, the University of Kansas Medical Center, assistant director of Clinical Research, co-program leader, the Drug Discovery, Experimental Therapeutics program, the University of Kansas Cancer Center, institutional principal investigator, South West Oncology Group (SWOG), discusses updates in optimal systemic therapy strategies in early-stage triple-negative breast cancer (TNBC).

At the 40th Annual Miami Breast Cancer Conference®, Sharma reviewed data on neoadjuvant polychemotherapy, the role of platinum-based chemotherapy, studies investigating the addition of immunotherapy to chemotherapy, the role of capecitabine for patients with residual disease, and the use of the PARP inhibitor olaparib (Lynparza) in the setting of residual disease.

She also discussed the lack of biomarkers currently available that can help determine which patients may benefit most from a specific chemotherapy regimen or immunotherapy. Conversely, there remains a need to identify biomarkers to help identify patients who are not likely to benefit from immunotherapy, Sharma expands. Although there is ongoing research aimed at identifying these predictive biomarkers, there are currently no specific biomarkers that can be used in clinical practice to help inform preoperative chemotherapy/immunotherapy decisions, Sharma notes.

Outside of biomarker research, other upcoming and ongoing trials could continue to help close some of the knowledge gaps that currently exist in early-stage TNBC, Sharma continues. For example, one trial will look at the role of adjuvant pembrolizumab (Keytruda) in patients to achieve a pathological complete response (pCR) with neoadjuvant chemoimmunotherapy, Sharma adds. Patients who achieve a pCR can do well without any additional therapy, even in an absence of immunotherapy, so investigators aim to evaluate what benefit could be derived from 8 additional cycles of adjuvant pembrolizumab, Sharma concludes.