1. Association Between Biomarkers and Clinical Outcomes of Pembrolizumab Monotherapy in Patients With Metastatic Triple-Negative Breast Cancer: KEYNOTE-086 Exploratory Analysis.
- Author
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Loi, Sherene, Salgado, Roberto, Schmid, Peter, Cortes, Javier, Cescon, David W., Winer, Eric P., Toppmeyer, Deborah L., Rugo, Hope S., De Laurentiis, Michelino, Nanda, Rita, Iwata, Hiroji, Awada, Ahmad, Tan, Antoinette R., Sun, Yuan, Karantza, Vassiliki, Wang, Anran, Huang, Lingkang, Saadatpour, Assieh, Cristescu, Razvan, and Yearley, Jennifer
- Subjects
TRIPLE-negative breast cancer ,BIOMARKERS ,TREATMENT effectiveness ,HEMATOXYLIN & eosin staining ,GENE expression profiling - Abstract
PURPOSE: In the two-cohort phase II KEYNOTE-086 study (ClinicalTrials.gov identifier: NCT02447003), first-line and second-line or later pembrolizumab monotherapy demonstrated antitumor activity in metastatic triple-negative breast cancer (mTNBC; N = 254). This exploratory analysis evaluates the association between prespecified molecular biomarkers and clinical outcomes. METHODS: Cohort A enrolled patients with disease progression after one or more systemic therapies for metastatic disease irrespective of PD-L1 status; Cohort B enrolled patients with previously untreated PD-L1–positive (combined positive score [CPS] ≥ 1) metastatic disease. The association between the following biomarkers as continuous variables and clinical outcomes (objective response rate [ORR], progression-free survival [PFS], and overall survival [OS]) was evaluated: PD-L1 CPS (immunohistochemistry), cluster of differentiation 8 (CD8; immunohistochemistry), stromal tumor-infiltrating lymphocyte (sTIL; hematoxylin and eosin staining), tumor mutational burden (TMB; whole-exome sequencing [WES]), homologous recombination deficiency-loss of heterozygosity, mutational signature 3 (WES), mutational signature 2 (apolipoprotein B mRNA editing catalytic polypeptide–like; WES), T-cell–inflamed gene expression profile (Tcell
inf GEP; RNA sequencing), and 10 non-Tcellinf GEP signatures (RNA sequencing); Wald test P values were calculated, and significance was prespecified at α = 0.05. RESULTS: In the combined cohorts (A and B), PD-L1 (P =.040), CD8 (P <.001), sTILs (P =.012), TMB (P =.007), and Tcellinf GEP (P =.011) were significantly associated with ORR; CD8 (P <.001), TMB (P =.034), Signature 3 (P =.009), and Tcellinf GEP (P =.002) with PFS; and CD8 (P <.001), sTILs (P =.004), TMB (P =.025), and Tcellinf GEP (P =.001) with OS. None of the non-Tcellinf GEP signatures were associated with outcomes of pembrolizumab after adjusting for the Tcellinf GEP. CONCLUSION: In this exploratory biomarker analysis from KEYNOTE-086, baseline tumor PD-L1, CD8, sTILs, TMB, and Tcellinf GEP were associated with improved clinical outcomes of pembrolizumab and may help identify patients with mTNBC who are most likely to respond to pembrolizumab monotherapy. [ABSTRACT FROM AUTHOR]- Published
- 2023
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