Appointment sheet
Immunomodulatory triple-negative breast cancer (IM)
Prepared with OnCo (onco.cc/prep/tnbc-immunomodulatory/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
9 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Stromal tumour-infiltrating lymphocytes on the biopsy, PD-L1 combined positive score, Immune gene expression), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Metastatic, PD-L1 CPS 10 or more
- 5.For my situation (metastatic, pd-l1 cps 10 or more), which of the standard options do you recommend and why?
- 6.Am I a candidate for Pembrolizumab, and what side effects should I expect?
- 7.How do the results of KEYNOTE-355 apply to someone like me?
Any stage
- 8.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 9.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
The words I may hear
- PD-L1 combined positive score 10 in triple-negative breast cancer: In metastatic triple-negative breast cancer the immunotherapy pembrolizumab is only given when a PD-L1 stain of the tumour scores 10 or more on the combined positive score, because that is the group in which the trial showed people lived longer.
- Tumour-infiltrating lymphocytes (TILs): Immune cells that have got inside the tumour.
- Combined positive score (CPS): A PD-L1 score that counts stained tumour cells and immune cells together.
Tests and results to bring
Biomarker results to ask for: Stromal tumour-infiltrating lymphocytes on the biopsy (prognostic; de-escalation trials), PD-L1 combined positive score (metastatic pembrolizumab eligibility at 10 or more), Immune gene expression (research).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Metastatic, PD-L1 CPS 10 or more: Pembrolizumab with chemotherapy (KEYNOTE-355; NICE TA801) or with sacituzumab govitecan (ASCENT-04); the rows on the parent page. (KEYNOTE-355, Pembrolizumab, Combined positive score (CPS), PD-L1 combined positive score 10 in triple-negative breast cancer)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call