{"entity":{"id":"paper-asco-pembrolizumab-early-tnbc-rapid-update-jco-2022","kind":"paper","name":"Use of Immune Checkpoint Inhibitor Pembrolizumab in the Treatment of High-Risk, Early-Stage Triple-Negative Breast Cancer: ASCO Guideline Rapid Recommendation Update","aka":[],"tldr":"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.","asOf":"2026-09-24","links":[{"label":"J Clin Oncol 2022","url":"https://doi.org/10.1200/JCO.22.00503"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/35417251/"}],"tags":["tnbc-evidence"],"related":["paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021"],"cancers":["tnbc"],"sections":[],"technologies":["checkpoint-inhibitor"],"targets":[],"drugs":["pembrolizumab"],"companies":[],"institutions":["asco"],"pathways":[],"terms":[],"trials":["keynote-522","optimice-pcr"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2022,"doi":"10.1200/JCO.22.00503","pmid":"35417251","authors":"Korde LA, Somerfield MR, Hershman DL, et al.","paperType":"guideline","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."],"whatItMeans":"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."],"changedPractice":true},"route":"/key-papers/paper-asco-pembrolizumab-early-tnbc-rapid-update-jco-2022/","neighbours":{"paper":[{"id":"paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021","kind":"paper","name":"Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline","route":"/key-papers/paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021/"}],"cancer":[{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"institution":[{"id":"asco","kind":"institution","name":"American Society of Clinical Oncology (ASCO)","route":"/institutions/asco/"}],"trial":[{"id":"keynote-522","kind":"trial","name":"KEYNOTE-522","route":"/trials/keynote-522/"},{"id":"optimice-pcr","kind":"trial","name":"OptimICE-pCR (A012103)","route":"/trials/optimice-pcr/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}],"roadmap":[{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}]}}