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Neoadjuvant Durvalumab Shows Benefit in Triple-Negative Breast Cancer

David Rimm, MD, PhD
Published Online:9:00 PM, Thu January 2, 2020

David Rimm, MD, PhD, a pathologist at Yale University School of Medicine and professor in the Department of Pathology and Department of Medical Oncology, discusses the key takeaways from the results of a phase I/II trial presented in a poster at the 2019 San Antonio Breast Cancer Symposium, which evaluated neoadjuvant checkpoint inhibition in a small subset of patients with triple-negative breast cancer (TNBC).

A durvalumab (Imfinzi)-based regimen improved outcomes in patients with TNBC compared with chemotherapy alone. These findings were consistent with those of KEYNOTE-522, which evaluated the checkpoint inhibitor pembrolizumab (Keytruda) in a larger population. However, this small trial compared the antibody to PD-L1 ligand as opposed to in comparison with the PD-1 receptor in KEYNOTE-522, says Rimm.

The results were similar, according to Rimm, when compared between the 2 clinical trials. However, an increased likelihood in a pathologic complete response was noted in patients who expressed PD-L1 in the smaller study of durvalumab. This was not seen in KEYNOTE-522, where patients who were PD-L1-positive were similar to those who were PD-L1-negative. Rimm says,it is interesting to see an association between PD-L1 expression and response with durvalumab.
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