ESMO 2018: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer
Posted: Monday, October 29, 2018
In some patients with metastatic triple-negative breast cancer, the combination of the immunotherapy atezolizumab and the chemotherapy agent nab-paclitaxel improved survival, according to the late-breaking results from the IMpassion130 trial. These findings, which many experts believe may change the treatment landscape for women with triple-negative breast cancer, were presented at the European Society for Medical Oncology (ESMO) 2018 Congress in Munich (Abstract LBA1_PR).
According to the first study author, Peter Schmid, MD, PhD, FRCP, of London’s St. Bartholomew’s Breast Cancer Centre, Barts Health NHS Trust, this is the first immunotherapy to improve outcomes in this cancer type. “Most of the survival benefit was in patients with PD-L1–positive tumors,” he commented in an ESMO press release.
This phase III trial featured 902 patients with metastatic triple-negative breast cancer who had not received prior treatment for metastatic disease. They were randomly assigned to nab-paclitaxel plus atezolizumab or standard chemotherapy plus placebo.
At a median follow-up of 12.9 months, the combination therapy reduced the risk of disease worsening or death by 20% in all patients and 38% in the subgroup expressing PD-L1. In the entire study population, the median progression-free survival was 7.2 months with the combination therapy and 5.5. months with chemotherapy alone. In the PD-L1–positive subgroup, the median progression-free survival and overall survival were 7.5 months and 25.0 months, respectively, with the combination therapy and 5.0 months and 15.5 months, respectively, with chemotherapy alone.
As for the safety profile, the combination therapy appeared to be well tolerated, with most of the side effects thought to be due to chemotherapy. However, a minor increase in nausea and cough were observed in the group treated with the combination therapy.
