“An accelerated approval has been granted by the FDA for the combination of atezolizumab (Tecentriq) and nab-paclitaxel (Abraxane) as a frontline treatment for patients with unresectable locally advanced or metastatic PD-L1–positive triple-negative breast cancer (TNBC).
“The approval is based on the phase III IMpassion130 trial, in which the addition of the PD-L1 inhibitor atezolizumab to nab-paclitaxel reduced the risk of progression or death by 40% compared with nab-paclitaxel alone in this patient population.”
“Adding atezolizumab (Tecentriq) to nab-paclitaxel (Abraxane) and carboplatin in the frontline setting significantly improved overall survival (OS) in patients with advanced non–small cell lung cancer (NSCLC), according to findings from the phase III IMpower130 study.
“Atezolizumab also improved progression-free survival (PFS), the coprimary endpoint of the IMpower130 study, according to Genentech (Roche), the manufacturer of the PD-L1 inhibitor. The company plans to share the study data at an upcoming oncology meeting.”
“Treatment with nab-paclitaxel (Abraxane) showed promising improvements in overall survival (OS) and progression-free survival (PFS) compared with standard paclitaxel for patients with metastatic triple-negative breast cancer (TNBC), according to post-hoc findings from the CALGB 40502/NCCTG N063H trial presented at the 2017 San Antonio Breast Cancer Symposium (SABCS).
“For those with TNBC in the phase III trial (n = 201), the median OS with nab-paclitaxel was 21.0 months compared with 15.3 months with standard paclitaxel, representing a 26% reduction in the risk of death. Given the limitations of the post-hoc assessment, these findings were not powered for statistical significance, explained lead investigator Hope S. Rugo, MD. The hazard ratio for the comparison was 0.74 (95% CI, 0.51-1.07).”
“Combination regimens—particularly with checkpoint inhibitors and chemotherapy—are showing promise for the treatment of patients with squamous non–small cell lung cancer (NSCLC).
“Beyond the May 2017 FDA approval of pembrolizumab (Keytruda) plus carboplatin/pemetrexed for nonsquamous patients regardless of PD-L1 status, researchers are turning their focus to immunotherapy combinations in squamous patients in ongoing clinical trials. For example, the randomized, open-label, phase III IMpower131 study is evaluating the safety and efficacy of atezolizumab (Tecentriq) in combination with carboplatin/paclitaxel or carboplatin/nab-paclitaxel (Abraxane) versus carboplatin/nab-paclitaxel in chemotherapy-naïve patients with stage IV squamous NSCLC (NCT02367794). The trial, which has a primary endpoint of progression-free survival, is expected to enroll 1021 patients.”
“Combination regimens that pair nab-paclitaxel (Abraxane) with PD-L1 checkpoint blockade immunotherapy agents are emerging as a robust area of investigation in triple-negative breast cancer (TNBC), bolstered by clinical trial results that establish the chemotherapeutic agent as an effective partner for other therapies.
“Although nab-paclitaxel has been combined in some studies with other chemotherapies, the focus is shifting to regimens that include immunotherapies as the efficacy of that approach continues to grow. Nab-paclitaxel, an albumin-bound form of paclitaxel, is indicated for patients with metastatic breast cancer after prior chemotherapy.”
“Celgene Corporation (CELG) today announced that the results of its randomized phase II tnAcity trial of ABRAXANE® for injectable suspension (paclitaxel protein-bound particles for injectable suspension) (albumin-bound) will be presented at the 2016 San Antonio Breast Cancer Symposium (SABCS) December 6-10, 2016. The trial found that an investigational weekly combination regimen of ABRAXANE + carboplatin had significantly longer progression-free survival (PFS) (7.4 months) compared to weekly regimens of either ABRAXANE + gemcitabine (5.4 months) or of carboplatin + gemcitabine (6.0 months) as first-line treatment of patients with metastatic triple-negative breast cancer (mTNBC).”
“While recent findings from the I-SPY 2 trial have shown potential with the combination of ado-trastuzumab emtansine (T-DM1; Kadcyla) and pertuzumab (Perjeta) for patients with HER2-positive breast cancer, the neoadjuvant space still has a lot of work ahead, according to Lisa A. Carey, MD.
“Results presented at the 2016 AACR Annual Meeting1 showed that, out of the 249 patients enrolled on the I-SPY 2 study, 54% of those who received T-DM1/pertuzumab experienced a pathological complete response (pCR) rate compared with 22% of those who received the combination of paclitaxel (Abraxane) plus trastuzumab (Herceptin).
“This suggests that T-DM1 could increase overall survival (OS) in this patient population, but Carey adds more research with the regimen needs to be conducted.”
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“Upfront treatment with the PD-L1 inhibitor atezolizumab (MPDL3280A) plus nab-paclitaxel (Abraxane) showed a confirmed objective response rate (ORR) of 66.7% in patients with metastatic triple-negative breast cancer (TNBC), according to data presented at the 2015 San Antonio Breast Cancer Symposium.
“In the phase Ib study, atezolizumab plus nab-paclitaxel was explored across several lines of treatment regardless of PD-L1 status for patients with metastatic TNBC. In the second-line setting, the confirmed ORR was 25% and in the third-line and beyond the ORR was 28.6%. Across the full trial, the ORR was 41.7%.
“ ‘For the efficacy, we saw a very high response rate, which is extremely exciting and encouraging,’ said lead investigator Sylvia Adams, MD, associate professor of Medicine, NYU Perlmutter Cancer Center. ‘The combination was well-tolerated without additive toxicity. We saw only toxicity that was predictable for the single agents alone.’ “
“Sequential doxorubicin plus cyclophosphamide followed by weekly paclitaxel is a reasonable adjuvant treatment option for triple-negative breast cancer, according to 12-year follow-up of the Eastern Cooperative Oncology Group’s E1199 phase III trial evaluating optimal taxane type and scheduling in operable breast cancer.
“No similar benefits were observed for patients with hormone receptor-positive tumors or disease not overexpressing HER-2, and obesity and black race were found to be independently associated with recurrence and death, reported investigators online in the Journal of Clinical Oncology.
” ‘Improved outcomes initially observed for weekly paclitaxel were qualitatively similar but quantitatively less pronounced with longer follow-up, although exploratory analysis suggested substantial benefit in triple-negative disease,’ wrote multicenter researchers led by Joseph A. Sparano, MD, a medical oncologist at Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, N.Y.
“Updating their 5-year findings, they reported on almost 5,000 eligible women with stage II-III breast cancer treated with four cycles of doxorubicin plus cyclophosphamide. The four-arm trial then randomly assigned them to receive paclitaxel or docetaxel on a standard schedule every three weeks for four doses, or weekly for 12 doses using a 2 x 2 factorial design, with the regimens designated as P3, P1, D3, and D1, respectively. The primary endpoint was disease-free survival (DFS).”