Breast cancer immunotherapy: a jaw-dropping 290 trials are underway

  • JAMA Oncol

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Breast cancer is the focus of 290 ongoing immunotherapy clinical trials, with immune checkpoint blockade (ICB) leading the way in nearly 200 of them.
  • ICB is most commonly paired with chemotherapy, another immunotherapy, or other type of therapy.
  • Triple-negative breast cancer (TNBC) is the most common breast cancer subtype being studied (>100 trials), followed by any subtype (>20), or HER2+ subtype (>20).

Why this matters

  • The authors predict that immunotherapy's success will most likely rest with combination therapy.

Key points

  • The FDA recently approved the first ICB agent (atezolizumab) in combination with nab-paclitaxel for metastatic TNBC.
  • Of 290 trials, 13 are in phase 3 and nearly 200 are in phase 2.
  • Of 13 ICB trials targeting CTLA-4 or PD1/PD-L1 in metastatic breast cancer, half involve monotherapy and half are investigating combination therapy.
  • Early breast cancer with neoadjuvant ICB+chemotherapy is being studied in 4 trials.
    • 2 of them have reached phase 2: 1 with pembrolizumab+paclitaxel in multiple breast cancer subtypes (I-SPY) and the other with durvalumab+nab-paclitaxel for TNBC.
  • New outcome measures are being sought because a major obstacle is the lack of robust predictive biomarkers for ICB response.

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