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Pembrolizumab + Chemo Beneficial for Early-Stage Triple-Negative Breast Cancer

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Overall survival higher in group receiving pembrolizumab plus chemo versus chemotherapy alone

By Elana Gotkine HealthDay Reporter

THURSDAY, Sept. 19, 2024 (HealthDay News) — For patients with early-stage triple-negative breast cancer, neoadjuvant pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab yields a significant improvement in overall survival compared with neoadjuvant chemotherapy alone, according to a study published online Sept. 15 in the New England Journal of Medicine to coincide with the annual meeting of the European Society for Medical Oncology, held from Sept. 13 to 17 in Barcelona, Spain.

Peter Schmid, M.D., from the Barts Cancer Institute at Queen Mary University of London, and colleagues randomly assigned patients with previously untreated stage II or III triple-negative breast cancer to receive neoadjuvant therapy with four cycles of pembrolizumab or placebo plus paclitaxel and carboplatin, followed by four cycles of pembrolizumab or placebo plus doxorubicin-cyclophosphamide or epirubicin-cyclophosphamide. After definitive surgery, patients received adjuvant pembrolizumab (pembrolizumab-chemotherapy group; 784 patients) or placebo (placebo-chemotherapy group; 390 patients) for up to nine cycles. Patients were followed for a median of 75.1 months to the data-cutoff date of March 22, 2024.

The researchers found that at 60 months, the estimated overall survival was 86.6 and 81.7 percent in the pembrolizumab-chemotherapy and placebo-chemotherapy groups, respectively. Adverse events were consistent with established safety profiles.

“These results provide further support for pembrolizumab plus neoadjuvant chemotherapy followed by adjuvant pembrolizumab as treatment for high-risk, early-stage triple-negative breast cancer,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including Merck, which manufactures pembrolizumab and funded the study.

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