Topics:
Breast Cancer • Medical Oncology • NCI-CCC Tumor Board Question • Triple negative • University of Iowa • NCI-CCC Breast Tumor Board Question • Breast Cancer, Non-metastatic
In patients with localized triple-negative breast cancer and residual disease at time of surgery following neoadjuvant KEYNOTE-522 regimen, when would you recommend adding adjuvant capecitabine or another agent to pembrolizumab?
Patient is BRCA 1/2 wild type; completed four cycles of carboplatin/paclitaxel and two cycles of AC with pembrolizumab in the neoadjuvant setting.
Answer from: Medical Oncologist at Community Practice
While there is limited data at this time to support or refute the need for adjuvant oral therapies (i.e., capecitabine or olaparib) in combination with adjuvant pembrolizumab in patients with residual disease after neoadjuvant KEYNOTE-522 treatment, I have been using combination therapy in most pati...
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Answer from: Medical Oncologist at Academic Institution
At this time, there is limited data to support the decision but I have been proceeding with the combination in patients with residual disease in this scenario, especially if RCB-II to III. Here is my rationale. Further studies are needed in this area. KEYNOTE-522 (Schmid et al., PMID 32101663) ...