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Chemoimmunotherapy Ups Survival in Triple-Negative Breast Cancer

Atezolizumab plus nab-paclitaxel prolongs progression-free survival in metastatic disease

MONDAY, Oct. 22, 2018 (HealthDay News) — For patients with metastatic triple-negative breast cancer, atezolizumab plus nanoparticle albumin-bound (nab)-paclitaxel prolongs progression-free survival compared with placebo plus nab-paclitaxel, according to a study published online Oct. 20 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the European Society for Medical Oncology, held from Oct. 19 to 23 in Munich.

Peter Schmid, M.D., Ph.D., from the Queen Mary University of London, and colleagues randomly assigned patients with untreated metastatic triple-negative breast cancer to receive either atezolizumab plus nab-paclitaxel or placebo plus nab-paclitaxel in a 1:1 ratio (451 patients in each group). Patients continued the intervention until disease progression or an unacceptable level of toxic effects.

The researchers found a median progression-free survival of 7.2 and 5.5 months with atezolizumab plus nab-paclitaxel and placebo plus nab-paclitaxel, respectively (hazard ratio [HR] for progression or death, 0.80; 95 percent confidence interval [CI], 0.69 to 0.92; P = 0.002) in the intention-to-treat analysis. The median progression-free survival was 7.5 and 5.0 months, respectively, among patients with programmed death ligand 1 (PD-L1)-positive tumors (HR, 0.62; 95 percent CI, 0.49 to 0.78; P < 0.001). Median overall survival was 21.3 and 17.6 months, respectively, in the intention-to-treat analysis (HR for death, 0.84; 95 percent CI, 0.69 to 1.02; P = 0.08) and 25.0 and 15.5 months, respectively, among patients with PD-L1-positive tumors (HR, 0.62; 95 percent CI, 0.45 to 0.86).

“It remains to be determined whether these findings extend to other chemoimmunotherapy combinations,” the authors write.

The trial was funded by F. Hoffmann-La Roche/Genentech, which manufactures atezolizumab.

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