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How do you treat a patient with TNBC, BRCA WT, who received KEYNOTE-522 with residual disease post neoadjuvant therapy?

Would you offer adjuvant Pembrolizumab combined with Capecitabine?
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What adjuvant therapy would you offer a patient with TNBC, BRCA WT, who received KEYNOTE-522 with residual disease post neoadjuvant therapy?

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3 Answers
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Medical Oncology · Harvard Medical School
Answered on

Yes, in this (unfortunately high-high-risk) situation, I would continue adjuvant pembrolizumab as per the KEYNOTE-522 trial, and add adjuvant capecitabine per the CREATE-X trial. Though these two agents were not specifically studied together in this exact setting, there is other safety data to reass...

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Medical Oncology · British Columbia Cancer Agency
Answered on

Yes, in this situation, these are patients at higher risk of recurrent disease. Would continue pembrolizumab and offer capecitabine adjuvant therapy. There is safety data for this combination (Page et al., Journal of Clinical Oncology 2018) published in metastatic breast cancer, with no alarm sympto...

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Medical Oncology · Ohio State University
Answered on

Given that KEYNOTE-522 did not allow adjuvant capecitabine in patients who had residual disease following neo-adjuvant chemotherapy, we do not have data about the safety and efficacy of capecitabine together with pembrolizumab in this clinical setting. One could certainly make a case for changing pe...

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