KEYNOTE-355: pembrolizumab plus chemotherapy for PD-L1-positive advanced triple-negative breast cancer
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.
Overview
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.
In 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.
- 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.
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.
- No benefit demonstrated below a combined positive score of 10.
- The chemotherapy partner was chosen by the investigator.
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