Dr. O'Shaughnessy on Role of Chemotherapy in Future TNBC Treatment

Joyce A. O’Shaughnessy, MD
Published: Tuesday, Mar 28, 2017



Joyce A. O’Shaughnessy, MD, chair of Breast Cancer Research and the Celebrating Women Chair in Breast Cancer at Baylor-Sammons Cancer Center, Texas Oncology, and chair of The US Oncology Network, and 2016 Giant of Cancer Care® in Community Outreach, discusses the future role of chemotherapy in the treatment landscape of triple-negative breast cancer (TNBC).

In TNBC, it will become very important to combine the most effective chemotherapy agents with promising targeted therapies or immunotherapies, explains O'Shaughnessy. For example, monotherapy with the PD-1 and PD-L1 agents, pembrolizumab (Keytruda) and atezolizumab (Tecentriq), respectively, are showing approximately 20% response rates and 30% clinical benefit rates in very heavily pretreated patients.

However, when these agents are administered in earlier settings and in combination with chemotherapies such as nab-paclitaxel (Abraxane), there are signs of significant activity, she says. Pilot trials are looking at these immunotherapies added to preoperative standard chemotherapy for patients with locally advanced TNBC.

Whether it is the curative or metastatic setting, clinicians will continue to utilize chemotherapy for TNBC, but the future will likely involve using it in combination regimens.


Joyce A. O’Shaughnessy, MD, chair of Breast Cancer Research and the Celebrating Women Chair in Breast Cancer at Baylor-Sammons Cancer Center, Texas Oncology, and chair of The US Oncology Network, and 2016 Giant of Cancer Care® in Community Outreach, discusses the future role of chemotherapy in the treatment landscape of triple-negative breast cancer (TNBC).

In TNBC, it will become very important to combine the most effective chemotherapy agents with promising targeted therapies or immunotherapies, explains O'Shaughnessy. For example, monotherapy with the PD-1 and PD-L1 agents, pembrolizumab (Keytruda) and atezolizumab (Tecentriq), respectively, are showing approximately 20% response rates and 30% clinical benefit rates in very heavily pretreated patients.

However, when these agents are administered in earlier settings and in combination with chemotherapies such as nab-paclitaxel (Abraxane), there are signs of significant activity, she says. Pilot trials are looking at these immunotherapies added to preoperative standard chemotherapy for patients with locally advanced TNBC.

Whether it is the curative or metastatic setting, clinicians will continue to utilize chemotherapy for TNBC, but the future will likely involve using it in combination regimens.



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