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Atezolizumab and nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: Biomarker Evaluation of the IMpassion130 Study
- Source :
- JNCI Journal of the National Cancer Institute, Journal of the National Cancer Institute, vol 113, iss 8
- Publication Year :
- 2021
- Publisher :
- Oxford University Press (OUP), 2021.
-
Abstract
- Background Understanding the impact of the tumor immune microenvironment and BRCA1/2-related DNA repair deficiencies on the clinical activity of immune checkpoint inhibitors may help optimize both patient and treatment selection in metastatic triple-negative breast cancer. In this substudy from the phase 3 IMpassion130 trial, immune biomarkers and BRCA1/2 alterations were evaluated for association with clinical benefit with atezolizumab and nab-paclitaxel (A+nP) vs placebo and nP in unresectable (P+nP) locally advanced or metastatic triple-negative breast cancer. Methods Patients were randomly assigned 1:1 to nab-paclitaxel 100 mg/m2 (days 1, 8, and 15 of a 28-day cycle) and atezolizumab 840 mg every 2 weeks or placebo until progression or toxicity. Progression-free survival and overall survival were evaluated based on programmed death-ligand 1 (PD-L1) expression on immune cells (IC) and tumor cells, intratumoral CD8, stromal tumor-infiltrating lymphocytes, and BRCA1/2 mutations. Results PD-L1 IC+ in either primary or metastatic tumor tissue was linked to progression-free survival and overall survival benefit with A+nP. PD-L1 IC+ low (26.9%; 243 of 902 patients) and high (13.9%; 125 of 902 patients) populations had improved outcomes that were comparable. Intratumoral CD8 and stromal tumor-infiltrating lymphocytes positivity (sTIL+) were associated with PD-L1 IC+ status; improved outcomes were observed with A+nP vs P+nP only in CD8+ and sTIL+ patients who were also PD-L1 IC+. BRCA1/2 mutations (occurring in 14.5% [89 of 612 patients]) were not associated with PD-L1 IC status, and PD-L1 IC+ patients benefited from A+nP regardless of BRCA1/2 mutation status. Conclusions Although A+nP was more efficacious in patients with richer tumor immune microenvironment, clinical benefit was only observed in patients whose tumors were PD-L1 IC+.
- Subjects :
- Oncology
Cancer Research
medicine.medical_treatment
Triple Negative Breast Neoplasms
B7-H1 Antigen
chemistry.chemical_compound
0302 clinical medicine
Monoclonal
Antineoplastic Combined Chemotherapy Protocols
Tumor Microenvironment
Lymphocytes
Humanized
Triple-negative breast cancer
Cancer
0303 health sciences
Articles
6.1 Pharmaceuticals
030220 oncology & carcinogenesis
AcademicSubjects/MED00010
medicine.medical_specialty
Paclitaxel
Clinical Trials and Supportive Activities
Oncology and Carcinogenesis
Antibodies, Monoclonal, Humanized
Antibodies
Olaparib
03 medical and health sciences
Lymphocytes, Tumor-Infiltrating
Immune system
Breast cancer
Clinical Research
Atezolizumab
Albumins
Internal medicine
Breast Cancer
medicine
Humans
Tumor-Infiltrating
Oncology & Carcinogenesis
Progression-free survival
030304 developmental biology
Chemotherapy
Tumor-infiltrating lymphocytes
business.industry
Evaluation of treatments and therapeutic interventions
medicine.disease
Good Health and Well Being
chemistry
business
Biomarkers
Subjects
Details
- ISSN :
- 14602105 and 00278874
- Volume :
- 113
- Database :
- OpenAIRE
- Journal :
- JNCI: Journal of the National Cancer Institute
- Accession number :
- edsair.doi.dedup.....0a4daa288554717cfaddfd374c4734f0