Triple negative breast cancer: immunotherapy gives hope, reduces the risk of recurrence

Preoperative chemotherapy plus immunotherapy improve survival in women with early triple-negative breast cancer.

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Preoperative chemotherapy plus immunotherapy improve survival of affected women triple negative breast cancer at an early stage. It is the result of a study that demonstrated how an immunotherapy drug administered during surgery is capable of substantially reducing the risk of a relapse.

Il triple negative breast cancer it is one of the most aggressive and difficult to treat forms of breast cancer, affecting mainly young women and accounting for 10-20% of overall breast cancer diagnoses. It is so called because diseased cells do not have receptors for estrogen, progestogen and HER2 protein on their surface.

Now theimmunotherapy, which improves response to treatment and reduces the likelihood of cancer returning (and which earned James P. Allison and Tasuku Honjo the 2018 Nobel Prize in Medicine), could be the key to increasing cancer rates. survival of those facing this aggressive breast cancer.

A systematic review

This is a phase 3 study published in the New England Journal of Medicine, which involved nearly 1.200 women from 21 different countries with triple negative (second or third stage) breast cancer.

Before being operated on, the patients received a 6-month neoadjuvant therapy, which is chemotherapy that is performed before surgery or radiotherapy to reduce the size of the tumor and facilitate its removal. Not all, however, received the same treatment: 390 women were given standard chemotherapy in addition to a placebo, while the other group received the same chemotherapy drugs plus an immunotherapy, Pembrolizumab.

After the operation, radiotherapy and further administration of pembrolizumab for 27 weeks or a placebo, with the result that almost 65% of the women who received the neoadjuvant combination showed no signs of cancer at surgery, compared to just over 51% of patients undergoing chemotherapy alone.

"We have seen an almost 14% increase in the number of women without cancer, which is a huge step forward," says Peter Schmid, professor of oncology at Queen Mary University of London, to eCancer. Those who do not have cancer at the surgery are much less likely to get sick again, and this would be the first targeted treatment aimed at all women with early stage triple negative cancer ”.

Even none of the patients involved in the investigation had secondary tumors, in some the tumor also extended to the lymph nodes. In these cases, the risk of relapse is higher, but immunotherapy also gave positive results for these patients: almost 65% showed a complete pathological response after treatment compared to 44% of those who received only chemotherapy. Thus, an increase of almost 20%.

The results of the study are positive, but in most cases it has only been a little over a year since the surgery and in reality, for which, to confirm the data, the scholars need at least another five years of observation.

Fonte: New England Journal of Medicine / eCancer

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