Breast Cancer Clinical Case Review

In this video, Coral Omene, MD, PhD, assistant professor of medicine at Rutgers Robert Wood Johnson Medical School, and program director of Breast Cancer Disparities Research in the division of medical oncology at Rutgers Cancer Institute of New Jersey, reveals the chosen therapy.

Editor’s note: The following is an automatically generated transcript of the above video.

“For this patient, this regimen that we shall discuss was given preoperatively. This regimen that was selected for this patient was based on the KEYNOTE-522 clinical trial that looked at neoadjuvant pembrolizumab and chemotherapy followed by adjuvant pembrolizumab.

These patients with newly diagnosed triple negative breast cancer with either a T1c, N1-2 node disease, or T2-4 node negative and two disease, were essentially randomized to combination of immunotherapy with pembrolizumab and chemotherapy compared to chemotherapy with without immunotherapy. The chemotherapy drugs using this regimen includes carboplatin and paclitaxel given weekly for cycles one to four, followed by immunotherapy, with or without immunotherapy, but in this case, using doxorubicin and cyclophosphamide prior to surgery, and then this was followed by, in the adjuvant phase, immunotherapy alone.

In both settings, it was compared to placebo without immunotherapy. The primary endpoints were PCR as well as event-free survival, and what data showed was that for those patients who received a combined pembro-chemo regimen, they had improved PCR rates compared to those who just had chemotherapy alone. And this translated to survival benefit, as you can clearly see here that those patients who received the combined immuno and chemotherapy agents had fewer events, less deaths, and as you can clearly see from the curves, they had higher event-free survival, and this became part of the guidelines and standard of care to offer these high-risk patients stage two and three triple negative breast cancer this KEYNOTE-522 regimen.”