Postoperative Checkpoint Inhibitors for Early-Stage Triple-Negative Breast Cancer?

No. The addition of atezolizumab to adjuvant chemotherapy did not improve outcomes compared with chemotherapy alone.

Immunotherapy improves outcomes for patients with early-stage triple-negative breast cancer (TNBC), but how to optimally use it and in which patients remain open questions. The KEYNOTE-522 trial showed that the addition of pembrolizumab to preoperative chemotherapy increased pathological complete response rate and improved event-free and overall survival (NEJM JW Oncol Hematol Feb 11 2022 and N Engl J Med 2022; 386:556). Trial participants continued pembrolizumab postoperatively, although the contribution of the postoperative component to overall outcome is still debated.

There are patients who undergo surgery as a first step, either by design or because they do not meet the eligibility criteria for the KEYNOTE-522 regimen, but their patholo…

Reviewing Author

William J. Gradishar, MD

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery; Breast Cancer Research and Treatment

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)