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Posted by on Jan 12, 2020 in Breast cancer | 0 comments

In a nutshell

This study aimed to investigate the effectiveness and safety of atezolizumab plus nab-paclitaxel in unresectable, locally advanced or metastatic triple-negative breast cancer. 

This study concluded that this combination had a benefit in patients with PD-L1 immune cell positive metastatic triple-negative breast cancer.

Some background

Atezolizumab (Tecentriq) is a type of immunotherapy treatment known as a monoclonal antibody. Immunotherapy boosts the body's natural defenses to fight cancer. Nab-paclitaxel (Abraxane) is a chemotherapy used for breast and lung cancer. The combination of immunotherapy and chemotherapy has been effective in different tumor types.  

It was unknown if the combination of atezolizumab and nab-paclitaxel would be effective in patients with unresectable, locally advanced or metastatic triple-negative breast cancer (TNBC). 

Methods & findings

This study involved 902 patients with previously untreated, locally advanced or metastatic triple-negative breast cancer (TNBC). 451 patients received atezolizumab and nab-paclitaxel. 451 patients received a placebo and nab-paclitaxel. Patients were treated until disease progression or unacceptable side effects. Outcomes measured were progression-free survival (PFS) and overall survival (OS). The average follow-up time was 18.5 months in the atezolizumab group and 17.5 months in the placebo group.  

The average OS in the atezolizumab group was 21 months compared to 18.7 months in the placebo group. The average PFS was 7.2 months in the atezolizumab group compared to 5.5 months in the placebo group. 

The average OS in patients with PD-L1 immune cell-positive tumors was 25 months for the atezolizumab group compared to 18 months for the placebo group. PD-L1 immune cell-positive status means that patients have the PD-L1 protein on cancer cells. It predicts response to immunotherapy such as atezolizumab.

49% of patients in the atezolizumab group had serious side effects. This was compared to 43% in the placebo group. The most common serious side effects were neutropenia (low level of white blood cells; 8% in each group), nerve damage (6% – atezolizumab vs. 3% – placebo), decreased white blood cell count (5% – atezolizumab vs. 4% – placebo) and tiredness (4% – atezolizumab vs. 3% – placebo).  

The bottom line

This study concluded that atezolizumab and nab-paclitaxel combination provides benefit in patients with PD-L1 immune cell-positive advanced TNBC. 

The fine print

This study was funded by F Hoffmann-La Roche and Genentech, the manufacturer of atezolizumab.

Published By :

The Lancet. Oncology

Date :

Nov 27, 2019

Original Title :

Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial.

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