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ESMO 2017: Nivolumab After Induction Therapy in Triple-Negative Breast Cancer

Posted: Tuesday, September 12, 2017

The use of nivolumab after modulation of the tumor microenvironment with either irradiation or chemotherapy may prove to be an effective therapy for unselected patients with metastatic triple-negative breast cancer, according to the phase II TONIC trial. Marleen Kok, MD, PhD, of the Netherlands Cancer Institute, Amsterdam, presented the findings of this randomized study at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA14).

In this adaptive noncomparative trial, patients were assigned to one of several 2-week induction groups, which included irradiation of one metastatic lesion, doxorubicin, cyclophosphamide, cisplatin, or no induction therapy. Then all of them received nivolumab.

Thus far, 50 patients are evaluable for response at a median follow-up of 10.8 months. The objective response rate with nivolumab for the entire study cohort was 22%, with 1 complete response, 11 partial responses, and 1 stable disease lasting for more than 24 weeks. Preliminary results seemed to suggest a higher response rate after induction therapy with doxorubicin or cisplatin.

To put these data in perspective, the investigators noted that previous research has shown a relatively low response rate (of about 5%–10%) to anti–programmed cell death ligand 1 therapy in patients with metastatic triple-negative breast cancer.