{"entity":{"id":"paper-keynote-355-nejm-2022","kind":"paper","name":"KEYNOTE-355: pembrolizumab plus chemotherapy for PD-L1-positive advanced triple-negative breast cancer","aka":[],"tldr":"Adding pembrolizumab to first-line chemotherapy lengthened survival by almost seven months in advanced triple-negative breast cancer whose tumours had a PD-L1 combined positive score of 10 or more.","summary":"Phase 3 placebo-controlled trial of 847 patients with previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer randomised 2:1 to pembrolizumab or placebo with nab-paclitaxel, paclitaxel or gemcitabine-carboplatin.\n\nIn patients with a combined positive score of 10 or more, median overall survival was 23.0 versus 16.1 months (hazard ratio 0.73); no significant benefit was seen at lower PD-L1 scores.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2022","url":"https://doi.org/10.1056/NEJMoa2202809"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/35857659/"}],"tags":[],"related":[],"cancers":["tnbc-metastatic"],"sections":[],"technologies":[],"targets":[],"drugs":["pembrolizumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["keynote-355"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2022,"doi":"10.1056/NEJMoa2202809","pmid":"35857659","authors":"Cortes J, Rugo HS, Cescon DW, et al.","paperType":"rct","findings":["Median overall survival 23.0 vs 16.1 months in combined positive score 10 or more; hazard ratio 0.73.","Median progression-free survival 9.7 vs 5.6 months in the same group."],"whatItMeans":"PD-L1 testing with the combined positive score decides first-line treatment in metastatic triple-negative breast cancer; pembrolizumab-chemotherapy is the standard for scores of 10 or more.","caveats":["No benefit demonstrated below a combined positive score of 10.","The chemotherapy partner was chosen by the investigator."],"changedPractice":true,"participants":847},"route":"/key-papers/paper-keynote-355-nejm-2022/","neighbours":{"cancer":[{"id":"tnbc-metastatic","kind":"cancer","name":"Metastatic triple-negative breast cancer","route":"/cancers/tnbc-metastatic/"}],"drug":[{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"trial":[{"id":"keynote-355","kind":"trial","name":"KEYNOTE-355","route":"/trials/keynote-355/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}