Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial

Mittendorf, Elizabeth A.; Zhang, Hong; Barrios, Carlos H.; Saji, Shigehira; Jung, Kyung Hae; Hegg, Roberto; Koehler, Andreas; Sohn, Joohyuk; Iwata, Hiroji; Telli, Melinda L.; Ferrario, Cristiano; Punie, Kevin; Penault‐Llorca, Frédérique; Patel, Shilpen; Duc, Anh Nguyen; Liste-Hermoso, Mario; Maiya, Vidya; Molinero, Luciana; Chui, Stephen Y.; Harbeck, Nadia

doi:10.1016/s0140-6736(20)31953-x

Cited by 782 publications

(725 citation statements)

References 28 publications

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“…35 Higher rate of pCR was observed with the addition of pembrolizumab (64.8% vs 51.2%, P < .001). Similarly, another phase 3 randomized study IMpassion 031 36 randomized stage II and III TNBC to atezolizumab + nab-paclitaxel followed by atezolizumab and AC, or placebo + nab-paclitaxel followed by AC. Pathological complete response was observed in 57.6% in the atezolizumab arm, versus 41.1% in the placebo arm ( P = .0044).…”

Section: Nac For Tnbc and Subgroup Classification Using Gene-expressimentioning

confidence: 99%

Neoadjuvant Chemotherapy for Breast Cancer: Past, Present, and Future

Asaoka

Gandhi

Ishikawa

et al. 2020

Breast Cancer�(Auckl)

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Neoadjuvant chemotherapy (NAC) had been developed as a systematic approach before definitive surgery for the treatment of locally advanced or inoperable breast cancer such as inflammatory breast cancer in the past. In addition to its impact on surgery, the neoadjuvant setting has a benefit of providing the opportunity to monitor the individual drug response. Currently, the subject of NAC has expanded to include patients with early-stage, operable breast cancer because it is revealed that the achievement of a pathologic complete response (pCR) is associated with excellent long-term outcomes, especially in patients with aggressive phenotype breast cancer. In addition, this approach provides the unique opportunity to escalate adjuvant therapy in those with residual disease after NAC. Neoadjuvant chemotherapy in breast cancer is a rapidly evolving topic with tremendous interest in ongoing clinical trials. Here, we review the improvements and further challenges in the NAC setting in translational breast cancer research.

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Section: Nac For Tnbc and Subgroup Classification Using Gene-expressimentioning

confidence: 99%

Neoadjuvant Chemotherapy for Breast Cancer: Past, Present, and Future

Asaoka

Gandhi

Ishikawa

et al. 2020

Breast Cancer�(Auckl)

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“…This humble benefit did not lead to a better overall survival and was not recapitulated when using paclitaxel as concomitant chemotherapy nor consistently associated to any predictive biomarker other than PD-L1 (6). Findings seem to be more clinically meaningful in the neoadjuvant setting, in which an increased pathological complete response rate has been reported in patients receiving atezolizumab (58 vs 41% for total population, 69 vs 49% in PD-L1 positive tumors) (7). This body of evidence underscores the need of a better understanding of the tumorimmune interaction, escape mechanisms, and the role of the microenvironment when a high tumor burden exists.…”

Section: Introductionmentioning

confidence: 83%

Adoptive Cell Therapy in Breast Cancer: A Current Perspective of Next-Generation Medicine

et al. 2020

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“…The primary endpoint was pCR in the intention-to-treat population and in the PD-L1-positive population. There was a significant increase in the pCR rate in patients who received atezolizumab compared to patients who received placebo, regardless of PD-L1 expression [38].…”

Section: Efficacymentioning

confidence: 88%

“…Details on the efficacy and toxicity of the aforementioned schemes are depicted in Tables 1 and 2, respectively. More recently, the IMpassion031, a phase III, randomised, double-blind study, evaluating the use of immunotherapy in early-stage TNBC, met its primary endpoint [38]. Overall, 333 patients were randomised to receive neoadjuvant chemotherapy (nab-paclitaxel followed by doxorubicin and cyclophosphamide) combined with atezolizumab versus chemotherapy compared to placebo and chemotherapy, followed by maintenance therapy with atezolizumab.…”

Section: Efficacymentioning

confidence: 99%

Neoadjuvant immunotherapy in breast cancer: a paradigm shift?

Fountzila

Ignatiadis

2020

ecancer

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Despite advances in clinical management, a proportion of patients with early-stage triplenegative breast cancer (TNBC) recur after local treatment. The concept of neoadjuvant systemic therapy has been widely adopted to improve clinical outcomes of patients with TNBC and other breast tumour types. Recently, promising data were reported from the first prospective phase III, randomised trial assessing neoadjuvant chemotherapy combined with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab versus placebo in patients with early-stage TNBC. The addition of pembrolizumab resulted in a significant increase in pathologic complete response (pCR) rates. Similarly, in the IMpassion031 trial, the use of atezolizumab in combination with neoadjuvant chemotherapy in patients with early-stage TNBC led to improved pCR rates compared to placebo, regardless of programmed death ligand 1 (PD-L1) expression. Ongoing trials are testing other PD-1/PD-L1 inhibitors in combination with neoadjuvant chemotherapy in TNBC and other tumour subtypes. However, not all patients benefit from the addition of immunotherapy, while a proportion of patients experiences serious adverse events. It is critical to identify predictive biomarkers of response, to accurately select patients who will benefit from immunotherapy, thus sparing the rest from ineffective treatments with unnecessary toxicity and treatment costs. In this review, we summarise the literature on reported and ongoing neoadjuvant clinical trials evaluating immunotherapy in breast cancer.

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Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial

Cited by 782 publications

References 28 publications

Neoadjuvant Chemotherapy for Breast Cancer: Past, Present, and Future

Neoadjuvant Chemotherapy for Breast Cancer: Past, Present, and Future

Adoptive Cell Therapy in Breast Cancer: A Current Perspective of Next-Generation Medicine

Neoadjuvant immunotherapy in breast cancer: a paradigm shift?

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