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Attend this session at the
2017 ASCO Annual Meeting!


Session: Breast Cancer—Local/Regional/Adjuvant

Type: Oral Abstract Session

Time: Monday June 5, 9:45 AM to 12:45 PM

Location: Hall D2

Pembrolizumab plus standard neoadjuvant therapy for high-risk breast cancer (BC): Results from I-SPY 2.

Sub-category:
Neoadjuvant Therapy

Category:
Breast Cancer—Local/Regional/Adjuvant

Meeting:
2017 ASCO Annual Meeting

Abstract No:
506

Citation:
J Clin Oncol 35, 2017 (suppl; abstr 506)

Author(s): Rita Nanda, Minetta C. Liu, Christina Yau, Smita Asare, Nola Hylton, Laura Van't Veer, Jane Perlmutter, Anne M. Wallace, Amy Jo Chien, Andres Forero-Torres, Erin Ellis, Heather Han, Amy Sanders Clark, Kathy S. Albain, Judy Caroline Boughey, Anthony D. Elias, Donald A. Berry, Douglas Yee, Angela DeMichele, Laura Esserman; I-SPY Network; The University of Chicago, Chicago, IL; The University of Texas MD Anderson Cancer Center, Houston, TX; Mayo Clinic, Rochester, MN; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; Abramson Cancer Center, Philadelphia, PA; Buck Institute for Age Research, Novato, CA; Quantum Leap Health Care Collaborative, San Francisco, CA; UC San Francisco, San Francisco, CA; University of California, San Francisco, San Francisco, CA; Gemini Group, Ann Arbor, MI; University of California San Diego Moores Cancer Center, La Jolla, CA; University of Alabama at Birmingham, Birmingham, AL; Swedish Cancer Inst, Seattle, WA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Hospital of the University of Pennsylvania, Philadelphia, PA; Loyola University Chicago Stritch School of Medicine, Cardinal Bernardin Cancer Center, Maywood, IL; University of Colorado Comprehensive Cancer Center, Aurora, CO

Abstract Disclosures

Abstract:

Background: Pembro is an anti-PD-1 antibody with single agent activity in HER2– metastatic BC. I-SPY 2 is a multicenter, phase 2 platform trial which evaluates novel neoadjuvant therapies; the primary endpoint is pathological complete response (pCR, ypT0/Tis ypN0). We report current efficacy results, with final results at ASCO. Methods: Patients (pts) with invasive BC ≥2.5 cm by exam or ≥2 cm by imaging are assigned weekly paclitaxel x 12 (control) +/- an experimental agent, followed by doxorubicin/cyclophosphamide x 4. Combinations of hormone-receptor (HR), HER2, & MammaPrint (MP) status define the 8 signatures studied. MP low HR+ BC is excluded. Adaptive randomization is based on each arm’s Bayesian probability of superiority over control. Graduation by signature is based on an arm’s Bayesian predictive probability of a successful 1:1 randomized phase 3 trial with a pCR endpoint. We provide raw & Bayesian estimated pCR rates adjusted for covariates, time effects over the course of the trial, & serial MRI modeling for pts not yet assessed for pCR surgically. Results: 69 pts were randomized to pembro (HER2- subsets only) from Dec 2015 until it graduated in Nov 2016. 46 pts have undergone surgery (table); the other 23 have on-therapy MRI assessments. In 29 HR–/HER2– (TNBC) pts, pembro increased raw & estimated pCR rates by >50% & 40%, respectively; in 40 HR+/HER– pts, it did so by 13% and 21%. 5 pts had immune-related grade 3 adverse events (AEs); 1 hypophysitis & 4 adrenal insufficiency. 4 pts presented after completion of AC (149-179 d after starting pembro); 1 presented prior to AC (37 d after starting pembro). 7 pts had grade 1-2 thyroid abnormalities. Conclusion: Pembro added to standard therapy improved pCR rates in all HER2- BCs that meet I-SPY 2 eligibility, especially in TNBC. Immune-mediated AEs were observed; pt follow up is ongoing. Clinical trial information: NCT01042379

SignatureCurrent raw data:
pCR/n
[total assigned]
Estimated pCR rate
(95% prob interval)
[equivalent n]
Prob pembro
superior
Pred prob of
success in phase III
PembroControlPembroControl
HR+/HER2–7/2513/8834.2%13.6%99.0%86.8%
(28.0%)(14.8%)(17-51%)(6-21%)
[40][99][29.4][72.4]
TNBC15/2116/8362.4%22.3%>99.9%99.3%
(71.4%)(19.3%)(45-80%)(12-33%)
[29][89][28.6][58.4]

 
Other Abstracts in this Sub-Category:

 

1. A phase III trial of neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2-blockade for HER2+ breast cancer: The TRAIN-2 study (BOOG 2012-03).

Meeting: 2017 ASCO Annual Meeting Abstract No: 507 First Author: Mette S. Van Ramshorst
Category: Breast Cancer—Local/Regional/Adjuvant - Neoadjuvant Therapy

 

2. A randomized, double-blind, phase III study comparing SB3 (trastuzumab biosimilar) with originator trastuzumab in patients treated by neoadjuvant therapy for HER2-positive early breast cancer.

Meeting: 2017 ASCO Annual Meeting Abstract No: 509 First Author: Xavier B. Pivot
Category: Breast Cancer—Local/Regional/Adjuvant - Neoadjuvant Therapy

 

3. Double-blind, randomized phase III study to compare the efficacy and safety of CT-P6, trastuzumab biosimilar candidate versus trastuzumab as neoadjuvant treatment in HER2 positive early breast cancer (EBC).

Meeting: 2017 ASCO Annual Meeting Abstract No: 510 First Author: Justin Stebbing
Category: Breast Cancer—Local/Regional/Adjuvant - Neoadjuvant Therapy

 

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