|Anti-PD-L1 antibodies combined with nab-paclitaxel improves outcome of patients with metastatic triple-negative breast cancer|
|Patients with triple-negative breast cancer (TNBC) have a poor prognosis, since no endocrine or targeted therapies are available for these patients. Programmed death ligand 1 (PD-L1) and its receptor PD-1 work together to block T cell functions as an immune check, thus blocking this signaling pathway unleashed T cell functions to execute anti-cancer killing. The field of cancer immunology has attracted interest of researchers and oncologists, as exciting results emerge.
In this phase 3, randomized trial, Dr. Schmid and colleagues tested the efficacy of anti-PD-L1 antibodies (atezolizumab) and nanoparticle albumin-bound (nab)-paclitaxel in untreated metastatic TNBC and published results in a recent issue of NEJM (here). All patients received nab-paclitaxel as the regimen of chemotherapy, whereas patients (451 participants) in the atezolizumab were treated with atezolizumab at a dose of 840 mg intravenously and individuals (451 participants) in the placebo group received the matched placebo. The primary endpoints were progression-free and overall survival.
After a median follow-up of 12.9 months, the median progression-free survival was 7.2 months in the atezolizumab group with respect to 5.5 months in the placebo group (hazard ratio, 0.80; 95% CI, 0.69 to 0.92; p<0.002). For those with PD-L1-positive tumors measured by immunohistochemistry, the median progression-free survival was 7.5 months in the atezolizumab group and 5.0 months in the placebo group, respectively (hazard ratio 0.62; 95%CI, 0.49 to 0.78; p<0.001). The median overall survival was 21.3 months in the atezolizumab group and 17.6 months in the placebo group, respectively (hazard ratio, 0.84: 95%CI, 0.69 to 1.02; p=0.08). For those with PD-L1-positive tumors, the median overall survival was 25.0 months in the atezolizumab group and 15.5 months in the placebo group, respectively (hazard ratio, 0.62; 95%CI, 0.45 to 0.86). No new adverse effects were reported.
Atezolizumab plus nab-paclitaxel prolonged progression-free survival in patients with untreated metastatic TNBC.
This study was supported by a pharmaceutical company.