Lajos Pusztai, MD, PhD

Lajos Pusztai, MD, DPhil, professor of Medicine (Medical Oncology), and co-leader of Genetics, Genomics, and Epigenetics at Yale Cancer Center, discusses recent data from the phase 3 KEYNOTE-522 trial (NCT03036488) of patients with triple-negative breast cancer (TNBC).

Data from the trial were presented during the 2022 American Society of Clinical Oncology (ASCO) and showed that an increased residual cancer burden (RCB) score was linked with worse event-free survival (EFS) in this patient population.

For patients administered pembrolizumab (Keytruda) and chemotherapy, there was an improvement in EFS compared with patients enrolled in the control arm who showed lower RBC scores.

 What we reported at ASCO was that in the final analysis, including all patients, the pathological cognitive response rate difference decreased from 13.6%-7.2%. That's still significant, but we also noticed that there was a consistent shift to lower amounts of residual cancer across the entire spectrum.

There were fewer patients in the RCB1 group in the pembrolizumab cohort than in the control cohort because many of them moved into the RCB0. There were fewer RCB2 patients in the pembrolizumab arm because many of them moved to the RCB1 category. There were fewer RCB3’s, which is the poorest prognosis and largest amount of residual cancer, and again, there were fewer of them in the pembrolizumab arm, approximately 5% of patients ended up with still this poor prognosis.

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Lajos Pusztai, MD, DPhil, discusses recent data from the phase 3 KEYNOTE-522 trial of patients with triple-negative breast cancer.


Updated Findings From the KEYNOTE-522 trial in TNBC

Pusztai says there are only three types of abnormalities that oncologists can pick up. The best examples of FDA-approved drugs for breast cancer are HER2-amplification and HER2-targeted therapies, such as trastuzumab.

Some abnormalities have also been successfully targeted in other diseases, such as EGFR mutations, which can be targeted with gefitinib in lung cancer.

A common and important question is whether or not the abnormalities in breast cancer confer the same degree of sensitivity to a targeted drug, as they do in other disease types, says Pusztai.

Lajos Pusztai, MD, PhD, professor of medicine (medical oncology), chief of Breast Medical Oncology, co-director, Cancer Genetics Research Program, Yale Cancer Center, discusses DNA abnormalities in breast cancer.

Lajos Pusztai, MD, PhD, Yale Cancer Center, discusses DNA abnormalities in breast cancer.


Lajos Pusztai, MD, PhD | Authors

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Updated Findings From the KEYNOTE-522 trial in TNBC

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