The most dangerous breast cancer: 3-year overall survival rate of combined immunotherapy before surgery is 95.2%

Breast cancer is the most common cancer in women. The latest global cancer burden data in 2020 shows that there will be 2.26 million new cases of breast cancer and 680,000 deaths worldwide in 2020. Breast cancer has replaced lung cancer as the number one cancer in the world.

With the development of breast cancer detection technology, many breast cancers can be detected at an early stage; at the same time, with the improvement of treatment technology, the 5-year survival rate of breast cancer patients has also been greatly improved.

Breast cancer has become one of the five cancers with the highest 5-year survival rate ( 90% ) in the United States;

The cancers with the highest 5-year survival rates in the United States, breast cancer has a 5-year survival rate of 90%

Data source: American Cancer Data Center, Surveillance, Epidemiology, and End Results (SEER) 18 registries, National Cancer Institute, 2021

But not all types of breast cancer have good treatment outcomes. About 15% of breast cancers are triple negative breast cancers (TNBC) , which are caused by estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor-2 (HER-2) deficiency Because of its name, endocrine therapy or HER2-targeted therapy is basically ineffective.

At present, chemotherapy is the main means to reduce the risk of recurrence and metastasis of early-stage triple-negative breast cancer. In operable patients, neoadjuvant therapy prior to surgery is considered an effective way to reduce the risk of breast cancer recurrence, including triple-negative breast cancer.

Recently, ESMO’s “Annals of Oncology” journal (journal impact factor 51.769) published the results of neoadjuvant chemotherapy for triple-negative breast cancer, which improved the 3-year overall survival rate of triple-negative breast cancer patients to 95.2% through immunocombination therapy.

Image source: Official website of “Annals of Oncology” journal

From 2016 to June to October 2017, a total of 174 patients entered the study, and the enrolled patients were randomized into the immunocombination therapy group (dulvalumab + paclitaxel) and the placebo group (placebo ). + Paclitaxel).

After surgery, the patient did not continue to receive durvalumab.

The primary objectives of the study included pathological complete response rate (pCR), and secondary clinical endpoints included invasive tumor recurrence-free survival (iDFS), distant disease-free survival (DDFS), and overall survival (OS).

The median follow-up time of this study was 43.7 months , and there was no significant increase in the pathological complete response rate in the immunocombination therapy group, but the remaining 3 indicators included 3-year survival rate without invasive tumor recurrence, Both the disease survival rate and the overall survival rate have increased significantly. The specific data are as follows:

The results of the study showed that the addition of the immune checkpoint inhibitor durvalumab to neoadjuvant chemotherapy can effectively improve survival, with a 3-year overall survival improvement of more than 10%.

Although this study has found that adding immunotherapy to neoadjuvant therapy can improve treatment outcomes, further studies are needed to confirm the duration and duration of immunotherapy in neoadjuvant treatment of patients with early-stage triple-negative breast cancer, the researchers said.

Use order to ensure that patients can get better treatment effect.

According to the principle of immunotherapy, when the patient’s immune system is more perfect, the effect of immunotherapy may be better.

In fact, in recent years, immunotherapy has also been advancing from the third and fourth line to the first line. In the field of neoadjuvant therapy, a previous Mount Sinai study found that the use of immunotherapy before surgery can make some liver cancer patients regress their tumors and avoid subsequent surgery, while increasing the overall survival of patients.

It is believed that with the progress of immunotherapy, cancer patients will have a longer survival time after treatment.

References:

S. Loibl, A. Schneeweiss, J. Huober, et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. DOI: https://doi.org/10.1016/j.annonc.2022.07. 1940