Currently Viewing:
Newsroom
Currently Reading
Atezolizumab Plus Chemotherapy Prolongs PFS in Triple-Negative Breast Cancer
October 23, 2018 – Samantha DiGrande
One Gene Could Be Responsible for Acute Myeloid Leukemia
October 21, 2018 – Laura Joszt
Cancer Care Pathway Utilization Reduces Cost in Breast Cancer
October 20, 2018 – Samantha DiGrande
Switchable CAR T Cells May Be Safer in Pancreatic Cancer
October 19, 2018 – David Bai, PharmD
What We're Reading: UnitedHealthcare Prefers Biosimilars; Migraine Coverage; Prostate Cancer Disparity
October 18, 2018 – AJMC Staff
Combination of Bleomycin and G-CSF Does Not Increase Risk for Bleomycin-Induced Pulmonary Toxicity
October 17, 2018 – Jaime Rosenberg
Opdivo Fails to Meet Primary Endpoint in Phase 3 SCLC Trial
October 17, 2018 – Samantha DiGrande
Three Genetic Types Drive Higher Prevalence of MM in African Americans
October 14, 2018 – Laura Joszt
ACOs Had No Significant Impact on Spending for Patients With Cancer
October 14, 2018 – Laura Joszt

Atezolizumab Plus Chemotherapy Prolongs PFS in Triple-Negative Breast Cancer

Samantha DiGrande
A phase 3 trial recently investigated if nanoparticle albumin-bound paclitaxel enhances the treatment of atezolizumab in unresectable locally advanced or metastatic triple-negative breast cancer. 
A phase 3 trial recently investigated if nanoparticle albumin-bound (nab)–paclitaxel enhances the treatment of atezolizumab in unresectable locally advanced or metastatic triple-negative breast cancer. The results were published in the New England Journal of Medicine,

Researchers randomly assigned patients with untreated metastatic triple-negative breast cancer in a 1:1 ratio to receive atezolizumab plus nab-paclitaxel or a placebo plus nab-placlitaxel. Patients continued on their assigned treatment until disease progression or an unacceptable level of toxicity. Stratification factors were if patients had undergone or not undergone neoadjuvant or adjuvant taxane therapy, the presence or absence of liver metastases at baseline, and programmed death ligand 1 (PD-L1) expression at baseline (positive versus negative). 

The 2 primary endpoints included progression-free survival (PFS), in the intention-to-treat population and PD-L1-positive subgroup, and overall survival, first tested in the intention-to-treat population; if the finding was significant, then it would be tested in the PD-L1–positive subgroup. 

In total, each arm of the study enrolled 451 patients with a median follow up of 12.9 months. The median PFS in the intention-to-treat arm was 7.2 months, compared with 5.5 months in the placebo plus nab-paclitaxel arm (hazard ratio [HR] for progression or death, 0.80; 95% CI, 0.69 to 0.92; = .002). Among patients with PD-L1-positive tumors, the median PFS was 7.5 months and 5 months, respectively (hazard ratio, 0.062, 95% CI, 0.49 to 0.78; <.001).

In terms of the second primary endpoint, the researchers found that in the intention-to-treat group, the median overall survival was 21.3 months, compared with 17.6 months in the placebo plus nab-paclitaxel (HR for death, 0.084; 95% CI, 0.69 to 1.02; = .08). In patients with PD-L1 positive tumors, the median overall survival was 25 months and 15.5 months, respectively (HR 0.62; 95% CI, 0.45 to 0.86). In addition, any identified adverse events were consistent with the known safety profiles of each agent.

Overall, the study authors found that atezolizumab plus nab-paclitaxel prolonged PFS among patients with metastatic triple-negative breast cancer in both the intention-to-treat population and the PD-L1–positive subgroup. However, the authors also noted that “It is important for patients’ PD-L1 expression status on tumor-infiltrating immune cells to be taken into consideration to inform treatment choices for patients with metastatic triple-negative breast cancer.”

Reference

Schmid P, Adams S, Rugo H. Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer [published online October 20, 2018]. N Engl J Med. doi: 10.1056/NEJMoa1809615

Related Articles

Atezolizumab Treatment Safe and Effective in Metastatic Urothelial Cancer Patients
Cancer Care Pathway Utilization Reduces Cost in Breast Cancer
Shorter Treatment Option Studied for HER2 Early Breast Cancer
 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up