Patients with early triple-negative breast cancer had improved outcomes with the addition of durvalumab (Imfinzi) to anthracycline and taxane-based chemotherapy as neoadjuvant therapy, according to a trial presented at the virtual American Society of Clinical Oncology annual meeting.
In this exclusive MedPage Today video, Jennifer Litton, MD, of MD Anderson Cancer Center in Houston, offers her takeaways from the GeparNUEVO study results.
Following is a transcript of her remarks:
GeparNUEVO was a study of 174 patients who received nab-paclitaxel and durvalumab followed by anthracycline-based chemotherapy with epirubicin and durvalumab, and then went to surgery. And it already presented, just like the IMpassion031 and the KEYNOTE-522 [trials], showing some improvement in pCR [pathologic complete response]. And, that had been 44.2% to 53.4% improvement. And what this did was actually looked at median followup at 43.7 months and showed that question that everyone’s asking for the use of immunotherapy — what about longer-term survival?
The 3-year invasive disease-free survival improved from 77.2% to 85.6%, the distant disease-free [survival] from 78.4% to 91.7%. And they’re seeing a separation in the overall survival, from 83.5% to 95.2%. And I think that this comes into a lot of the questions that we really have around endpoints for preoperative chemotherapy or preoperative systemic therapy trials. What is the Delta in [pCR] that matters? And I think that this also shows us that when we’re thinking about immunotherapy, the Delta and pCR isn’t the whole story. And seeing that a bigger separation that we’re seeing on the back end of it is something we’re going to really need to think about as we’re restructuring these trials for these endpoints.
I still am left with the same problem with triple-negative breast cancer, where so many of the people will do so well with a full [pCR] with very little. I hoped that this is the end of the days of, “Let’s throw all the patients with triple-negative breast cancer in the same study with one drug.” It’s one of the reasons I do love I-SPY and other kind of platforms that try to individualize therapy here. Because I think that we could be minimizing a bigger effect for a group of people who really need this, and that we’re certainly going to be exposing a lot of people to the long-term toxicity of immunotherapy that can be lifelong like the endocrinopathies, and they would have been cured completely with polychemotherapy alone, and maybe even less of that. So I think that we will absolutely, if the KEYNOTE [trial] is positive, we’ll be doing it, but I really think we need to be more thoughtful of how we’re going to figure out who really needs this or not.
Last Updated June 23, 2021
Source: MedicalNewsToday.com
