Would you consider adding pembrolizumab to adjuvant chemotherapy in a patient with stage 3 TNBC who did not receive neoadjuvant treatment?
TNBC diagnosed in 2nd trimester. Neoadjuvant rx not given due to complicated pregnancy and went straight to surgery due to HR+ biopsy. Surgical pathology confirmed TNBC. Although not standard of care, Ct-DNA post-op was found to be positive.
Answer from: Medical Oncologist at Community Practice
It seems that we might be missing some key clinical information here.
However, I assume that this was high risk enough - given the ki-67, potentially LN positive, and larger size tumor to make the treating physician concerned.
As a first point, while the ctDNA reflects (based on accumulating data)...
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Answer from: Medical Oncologist at Community Practice
It would be typical for high risk patients to have had neoadjuvant chemotherapy. The KEYNOTE-522 study used pembro as paclitaxel/carbo-pembro/AC neoadjuvantly, and continued pembro alone for 9 cycles in the adjuvant setting. So high risk TNBC patients should ideally get neoadjuvant pembro/chemo foll...
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Medical Oncologist at Overlook Medical Center
I would agree with Dr. @Hung T. Khong. While I app...
I would agree with Dr. @Hung T. Khong. While I app...
Answer from: Medical Oncologist at Community Practice
If she's BRCA positive, I'd favor olaparib per OlympiA trial over capecitabine per CREATE-X. The answer to the posed question, however, will probably wait until we have the results from SWOG S1418 (completed enrollment early this summer).