Residual disease post neoadjuvant chemo-immunotherapy in early triple-negative breast cancer: does it help tailor adjuvant treatment?

The treatment of early triple-negative breast cancer (TNBC) has changed with the results of the pivotal KEYNOTE-522 trial. 1 Schmid P. Cortes J. Pusztai L. et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020; 382: 810-821 Crossref PubMed Scopus (1430) Google Scholar This trial demonstrated that the addition of (neo)adjuvant pembrolizumab to a chemotherapy backbone including taxanes, carboplatin and anthracyclines was associated with a 7.2% absolute improvement in the rate of pathological complete response (pCR) (ypT0/Tis ypN0) and a 9% absolute improvement in the event-free survival (EFS) at a median follow-up of 63.1 months. 2 Schmid P. LBA18 - Pembrolizumab or placebo plus chemotherapy followed by pembrolizumab or placebo for early-stage TNBC: updated EFS results from the phase III KEYNOTE-522 study. Ann Oncol. 2023; 34: S1257 Abstract Full Text Full Text PDF Google Scholar Event-free survival by residual cancer burden with pembrolizumab in early-stage TNBC: exploratory analysis from KEYNOTE-522Annals of OncologyVol. 35Issue 5PreviewKEYNOTE-522 demonstrated statistically significant improvements in pathological complete response (pCR) with neoadjuvant pembrolizumab plus chemotherapy and event-free survival (EFS) with neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab in patients with high-risk, early-stage triple-negative breast cancer (TNBC). Prior studies have shown the prognostic value of the residual cancer burden (RCB) index to quantify the extent of residual disease after neoadjuvant chemotherapy. Full-Text PDF