6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement41st Annual Miami Breast Cancer Conference® - Abstracts
Volume 38
Issue 4
Pages: 10

6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population

6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population

Background

As a result of the KEYNOTE-522 trial demonstrating improved pathologic complete response (pCR) rates with the addition of pembrolizumab to neoadjuvant chemotherapy (NACT), the FDA approved the use of pembrolizumab in combination with NACT on July 26, 2021, for high-risk, early-stage triple-negative breast cancer (TNBC). Women who are Black are disproportionately affected by TNBC with more advanced stage at diagnosis; however, the KEYNOTE-522 trial did not collect information on race as a baseline demographic characteristic. Therefore, it is important to confirm the generalizability of the trial findings to patient populations who may have been underrepresented. This retrospective review aims to evaluate response to pembrolizumab plus NACT among a racially diverse patient population treated at a tertiary care center.

Methods

This is a single-center, retrospective review of patients with stage II/III TNBC diagnosed between August 2020-August 2023 and treated with pembrolizumab plus NACT at Maimonides Medical Center, a safety-net hospital in Brooklyn, New York, that serves a diverse patient population. Exclusion criteria included age younger than 18 years, estrogen receptor, progesterone receptor/HER2 positivity, NACT without pembrolizumab, and unreported race. Data were collected from electronic health records and analyzed using SPSS Statistics.

Results

Fifty patients met inclusion criteria, among whom 29 patients had complete information available for review. A total of 51.7% of patients identified as Black, 13.8% as White, 27.6% as Asian, and 6.9% as Latino; 48.3% of patients (95% CI, 30%-66%) had a pCR. A pCR was present in 25%, 46%, 50%, and 100% of White, Black, Asian, and Hispanic/Latino patients, respectively. Four patients had progression of disease with the development of distant metastasis (1 while on treatment and 3 following completion of therapy). One patient required hospitalization (adrenal insufficiency).

Conclusion

In this retrospective review of a racially diverse patient population, the pembrolizumab/NACT regimen was well tolerated with an acceptable adverse effect profile. While the rate of pCR is lower than the findings of the KEYNOTE-522 trial, in which 64.8% (95% CI, 59.9%-69.5%) of patients achieved a pCR, our sample size is not large enough to detect a statistically significant difference. The subanalysis of patient race demonstrated varying rates of pCR; however, findings are limited by a small sample size. Additional data collection is in progress, and future analysis will provide insight into a potential correlation between race and therapy response.

Articles in this issue

1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
3 Gender Disparities in the  National Institutes of Health  Funding for Breast Cancer
3 Gender Disparities in the National Institutes of Health Funding for Breast Cancer
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast  Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
13 The Cause and Eradication of Breast Cancer
13 The Cause and Eradication of Breast Cancer
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
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