IMpassion 130

Many patients still have doubts about the triple negative cancer diagnosis. There are some forms of treatment at the moment. Surgery is the most common, along with radiotherapy, which can be used as a complementary treatment in addition to chemotherapy.

However, a new medication protocol has been presented at ESMO 2018 that can have positive impacts for patients diagnosed with triple negative cancer.

What is triple-negative metastatic cancer?

The way the cancer is identified in the immunohistochemical analysis is what gives it the name: if it is identified the absence of the three receptors that classify breast cancer (HER2, estrogen and progesterone) in the cell examined, it is triple-negative breast cancer.

According to the Brazilian Society of Clinical Oncology (BSCO), triple-negative is relatively rare among cancer diagnoses, and although in some cases can be very aggressive, nowadays with the advance of technologies and research, we have the first study to document significant benefit of immunotherapy in metastatic breast cancer.

About the study

It was presented at the European Society for Medical Oncology (ESMO Congress 2018) the IMpassion 130, the first phase 3 study that showed great benefit of immunotherapy in this type of cancer.

The Impassion 130 study randomized two types of treatment in women with metastatic cancer. One of them was nab-paclitaxel (a medicine used to treat breast cancer) and placebo (a drug that has therapeutic effects) or the same nab-paclitaxel plus atezolizumab (monoclonal antibody used in the treatment of lung and bladder cancer).

There were 451 patients in total, 185 of them with presence of PD-L1 in their tumors. PD-L1 is the target of immunotherapy (atezolizumab) and its presence has been related to greater benefit of immunotherapy in several types of cancer.

These results showed that there was a longer-term control of the disease in the group treated with atezolizumab, together with nab-paclitaxel, even though this difference was simple. In the analysis of the group with PD-L1, control of the disease was higher, with a 38% risk reduction (which meant an increase of two and a half months in disease control) in favor of atezolizumab.

The most striking result was a 38% reduction in the risk of death (which represents 10 months in terms of overall survival -25 against 15.5 months for this treatment) in the group receiving atezolizumab.

SBOC’s standpoint

Thus, as it is a serious disease and still without many treatment options, and especially because of the many benefits that this can generate for patients, SBOC (Brazilian Society of Clinical Oncology) believes that it is very important that the regulatory authorities approve the combination of these two drugs (nab -paclitaxel and atezolizumab) for the treatment of women with metastatic triple-negative breast cancer.

This medication has already been approved the combination by the US drug agency, the FDA, on March 8, 2019.

It is worth to remember that it is necessary to ensure quality control in the identification of patients with this disease, as well as a good training for all physicians and pathologists to identify PD-L1, since this way, one can guarantee the accuracy in the treatment.