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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Wednesday, March 27, 2024
The final results of the phase III ALEXANDRA/IMpassion030 trial found that patients with triple-negative breast cancer do not seem to benefit from the addition of the monoclonal antibody atezolizumab to chemotherapy after surgery. Previous research had indicated immunotherapy added to chemotherapy before surgery may be of benefit in these patients. The study details were presented recently at the 2024 European Breast Cancer Conference (EBCC; Abstract 1LBA).
“The results of this final analysis are important because they show that including the immunotherapy drug atezolizumab alongside chemotherapy does not help when it’s given to patients following surgery,” said Heather McArthur, MD, of The UT Southwestern Medical Center, Dallas, in an EBCC press release. “By extension, this also highlights the importance of treating triple-negative breast cancer with chemotherapy and immunotherapy prior to surgery, as per the current standard of care.”
This study included 2,199 patients with stage II or III triple-negative breast cancer from more than 30 different countries. Patients were randomly assigned to receive chemotherapy plus atezolizumab following surgery, and the final analysis took place at 32 months of median follow-up. The primary endpoint was invasive disease–free survival, which was reported in 266 patients. Among the patients given chemotherapy plus atezolizumab, 141 experienced recurrence, compared with 125 who did not receive the combination. Of those given atezolizumab, 12.8% (n = 141) did not experience recurrence or mortality, compared with 11.4% (n = 125) of those who did not receive the monoclonal antibody—equating to a hazard ratio of 1.11 among those given atezolizumab and chemotherapy. In addition, the investigators saw no benefit with the experimental combination across different subgroups (those with lymph node–positive or PD-L1–positive disease). There was also a 54.3% incidence of grade ≥ 3 treatment-related adverse events in those who received chemotherapy plus atezolizumab.
Disclosure: For full disclosures of the study authors, visit eortc.org.
2024 European Breast Cancer Conference
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