Presented during ESMO Breast Cancer 2021, meta-analysis approaches immune checkpoint inhibitors (ICIs), which have shown promising antitumor activities in several malignancies
ESMO Breast Cancer 2021 starts today in virtual format, a multidisciplinary event aimed at researchers and oncologists interested in breast cancer, and covering different topics such as translational research, new drugs, molecular diagnoses, biomarkers, and oncology patient care.
At the congress, a meta-analysis evaluating the efficacy and safety profile of adding immune checkpoint inhibitors (ICIs) to neoadjuvant chemotherapy against triple-negative breast cancer.
Randomized clinical trials investigating ICI-containing neoadjuvant therapy versus ICI-free neoadjuvant therapy were included in the meta-analysis. Eligible studies were retrieved from PubMed, Embase and web of Web of Science.
The study included four randomized clinical trials containing 1,795 patients with early-stage triple-negative breast cancer. Neoadjuvant therapy associated with ICI significantly increased the pathologic complete response (pCR) rate compared to neoadjuvant therapy without ICI (OR = 2.14; 95% CI: 1.37 – 3.35; p < 0.001).
In a subgroup analysis, the addition of ICI to neoadjuvant chemotherapy was significantly associated with increased pCR rate in both PD-L1 positive (OR = 1.79; 95% CI: 1.33 – 2.41; P < 0.001) and PD-L1 negative (OR = 1.84; 95% CI: 1.14 – 2.99; P = 0.01) groups.
In addition, improved event-free survival was observed in the group with neoadjuvant therapy plus ICI versus the group without ICI (HR = 0.66, 95% CI: 0.48 – 0.89, P = 0.007).
A significantly increased risk of adverse events including adrenal insufficiency, increased aspartate aminotransferase, xerostomia, hepatitis, hyperthyroidism, infusion reactions, pyrexia, and stomatitis was observed with ICI-containing neoadjuvant therapy.
The authors conclude that ICI-containing neoadjuvant therapy significantly increased the pCR rate regardless of PD-L1 status in patients with early-stage triple-negative breast cancer, with an increase in event-free survival.