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possible practice changing TNBC treatment

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SagePatientAdvocates View Drop Down
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    Posted: Jul 16 2021 at 8:10am
Dear TNBC family,

from the link below

"Neoadjuvant pembrolizumab (Keytruda) plus chemotherapy, continued as a single agent after surgery, significantly improved event-free survival in patients with high-risk, early-stage triple-negative breast cancer (TNBC) in the KEYNOTE-522 trial.

The pembrolizumab regimen reduced the risk of progression, recurrence, second primary cancers, or death by 37% compared with neoadjuvant chemotherapy alone over a median follow-up of 39 months, reported Peter Schmid, MD, PhD, of Barts Cancer Institute at Queen Mary University of London, during a European Society Medical Oncology (ESMO) virtual plenary session.

"These data support that pembrolizumab plus platinum-containing neoadjuvant chemotherapy, followed by adjuvant pembrolizumab after surgery, should be a new standard of treatment for patients with high-risk early stage triple-negative breast cancer," Schmid said during his presentation.

In discussing the results of KEYNOTE-522, Giuseppe Curigliano, MD, PhD, of the University of Milan, Italy, called them "practice changing" and added that the best chemotherapy backbone for the pembrolizumab regimen still needs to be determined.

"But we know very well that the combination used in the KEYNOTE-522 trial really increased event-free survival," Curigliano said."

Here is a link to the article- 
 
https://www.medpagetoday.com/meetingcoverage/esmo/93598?xid=nl_mpt_DHE_2021-07-16&eun=g466704d0r&utm_source=Sailthru&utm_medium=email&utm_c

............................

I would suggest that any newly diagnosed women with TNBC ask their oncologists about the results of the Keynote-522 trial. Also, there was a controversial study about the MDM2 gene mutation that indicated that there could be hyperprogression if the person had the MDM2 mutation and then had immunotherapy.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6106866/

I am not a medical professional and am not suggesting that anyone take the Keytruda or not and whether they should get tested for the MDM2 mutation but I think it may warrant a discussion with your Breast Medical Oncologist.

Also, it is not clear to me, based on comments by Dr. Curigliano what chemo should be given with Keytruda in a neo-adjuvant setting.

with my love to all here,

Steve



Edited by SagePatientAdvocates - Jul 16 2021 at 8:30am
I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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123Donna View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Jul 16 2021 at 6:11pm
Steve,

Thank you for posting this update on Keytruda. 

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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