# Use of Immune Checkpoint Inhibitor Pembrolizumab in the Treatment of High-Risk, Early-Stage Triple-Negative Breast Cancer: ASCO Guideline Rapid Recommendation Update

Source: https://onco.cc/key-papers/paper-asco-pembrolizumab-early-tnbc-rapid-update-jco-2022/  
OnCo record `paper-asco-pembrolizumab-early-tnbc-rapid-update-jco-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The 2022 fast-track amendment in which the US oncology society added pembrolizumab before and after surgery for high-risk early triple-negative breast cancer, a year after its main guideline had said the evidence was insufficient.

## Summary

ASCO Rapid Recommendation Update by Korde, Somerfield, Hershman and the neoadjuvant therapy guideline expert panel. Rapid updates highlight revisions to selected ASCO guideline recommendations in response to new, practice-changing data, are supported by an evidence review and follow the ASCO Guideline Methodology Manual; their goal is to disseminate updated recommendations quickly. This update responded to the KEYNOTE-522 event-free survival result and the July 2021 US approval of pembrolizumab with chemotherapy as neoadjuvant treatment, continued as a single agent after surgery, for high-risk early-stage triple-negative breast cancer.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Journal of Clinical Oncology
- Year: 2022
- DOI: 10.1200/JCO.22.00503
- Authors: Korde LA, Somerfield MR, Hershman DL, et al.
- Findings: Rapid update mechanism: an evidence review and the ASCO methodology manual applied to a single practice-changing result.; Adds pembrolizumab with neoadjuvant chemotherapy, continued after surgery, for high-risk early-stage triple-negative breast cancer.
- What it means: Shows how quickly the standard moved: the 2021 guideline and its reversal are 15 months apart.
- Caveats: Abstract on Europe PMC describes the rapid update process rather than the recommendation wording; the recommendation is read from the article.; Does not address pembrolizumab omission after pathological complete response, now under test in OptimICE-pCR.

## Sources

- J Clin Oncol 2022: https://doi.org/10.1200/JCO.22.00503
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35417251/

## Connected records

- key papers: [Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline](https://onco.cc/key-papers/paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021/)
- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [Immune checkpoint inhibitors](https://onco.cc/technologies/checkpoint-inhibitor/)
- drugs: [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- institutions: [American Society of Clinical Oncology (ASCO)](https://onco.cc/institutions/asco/)
- trials: [KEYNOTE-522](https://onco.cc/trials/keynote-522/), [OptimICE-pCR (A012103)](https://onco.cc/trials/optimice-pcr/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)

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