
Primary results from IMpassion131, a double-blind, placebo-controlled, randomised phase III trial of first-line paclitaxel with or without atezolizumab for unresectable locally advanced/metastatic triple-negative breast cancer
2021; Elsevier BV; Volume: 32; Issue: 8 Linguagem: Inglês
10.1016/j.annonc.2021.05.801
ISSN1569-8041
AutoresDavid Miles, Joseph Gligorov, Fabrice André, David Cameron, Andreas Schneeweiß, Carlos H. Barrios, Binghe Xu, Andrew Wardley, Diego Kaen, Livia Andrade, Semiglazov Vf, Mattea Reinisch, Shilpen Patel, Monika Patre, L. Morales, Sipahee Lal Patel, M. Kaul, Teresa Barata, Joyce O’Shaughnessy, Q. Zhang, Binghe Xu, Zhimin Shao, Xiangyu Wang, Cuizhi Geng, Xingchen Yan, Zhongsheng Tong, Kunwei Shen, Yongmei Yin, Tao Sun, James Chih‐Hsin Yang, J. Feng, Min Yan, Yan Wang, Qiang Liu, S. Zhang, Michelino De Laurentiis, Armando Santoro, Valentina Guarneri, Marco Colleoni, Clara Natoli, Laura Cortesi, Sabino De Placido, Lorenzo Gianni, Francesco Ferraú, Lorenzo Livi, Alberto Zambelli, Lucia Del Mastro, Giuseppe Tonini, Filippo Montemurro, Giulia Bianchi, R. Pedersini, Salvatore A. Del Prete, Giacomo Allegrini, Giuseppe Naso, Patrizia Vici, D. Loirat, Audrey Mailliez, Franck Priou, Olivier Trédan, F. Dalenc, Christophe Perrin, Joseph Gligorov, M. Timar David, Nadine Dohollou, Luís Teixeira, Fabien Brocard, Antoine Arnaud, Suzette Delaloge, Jean‐Philippe Spano, Luigi Mansi, Livia Andrade, Fernanda Damian, José Luiz Pedrini, Sandra M. Aleixo, Roberto Hegg, Roberto Nery Dantas, Mattea Reinisch, Marcus Schmidt, C. Wenzel, E.‐M. Grischke, Andreas Schneeweiß, Marianne Just, Nadia Harbeck, Claudia Schumacher, Ubong Peters, Dorothea Fischer, Helmut Forstbauer, Rüdiger Liersch, Ellen Warner, Nathaniel Bouganim, C. T. Doyle, Julie Price Hiller, Ted Vandenberg, Michel Pavic, Andrew Robinson, Gloria Roldan Urgoiti, Nadia Califaretti, Ahmet Alacacıoğlu, Mahmut Gümüş, Bülent Yalçın, İrfan Çiçin, Fatih Köse, Kazım Uygun, Kaplan Ma, Erdem Çubukçu, Andrew Wardley, Mark Harries, David Miles, Dinesh Doval, Sameer Gupta, Prerana Mohapatra, Sanjoy Chatterjee, Nikhil Ghadyalpatil, Manish Singhal, Shubhadeep Nag, Amit Agarwal, Ido Wolf, Einav Gal Yam, Rinat Yerushalmi, T Peretz, Georgeta Fried, Noa Ben Baruch, Deborah A. Katz, E. Hamilton, Fadi Kayali, Adam Brufsky, Melinda L. Telli, Gail S. Wright, Raul H. Oyola, Thomas J. Rakowski, Stephanie L. Graff, Sergei Tjulandin, Semiglazov Vf, Ana M. Aparicio, Manuel Ruíz Borrego, Luis de la Cruz‐Merino, Joaquín G. Martínez, Escarlata López, Toshinari Yamashita, Shoichiro Ohtani, Kenichi Inoue, Yukako Ιtο, Naoki Niikura, Takahiro Nakayama, Yasuaki Sagara, Y. Yanagita, Yuhei Kamada, K. Kaneko, Diego Kaen, Adrián Nervo, Alexandru Eniu, Michael Schenker, Peter Priester, Bohuslav Melichar, Martina Zimovjanová, P. Sormova, Jozef Šufliarský, M. Kakalejcik, R. Belbaraka, Hassan Errihani, D. Than, Duc Thinh Pham, Gerasimos Aravantinos, Christos Papadimitriou, G. Koumakis, Christos N. Papandreou, Paula Podolski, Keo Tabane,
Tópico(s)Cancer Genomics and Diagnostics
ResumoIn the phase III IMpassion130 trial, combining atezolizumab with first-line nanoparticle albumin-bound-paclitaxel for advanced triple-negative breast cancer (aTNBC) showed a statistically significant progression-free survival (PFS) benefit in the intention-to-treat (ITT) and programmed death-ligand 1 (PD-L1)-positive populations, and a clinically meaningful overall survival (OS) effect in PD-L1-positive aTNBC. The phase III KEYNOTE-355 trial adding pembrolizumab to chemotherapy for aTNBC showed similar PFS effects. IMpassion131 evaluated first-line atezolizumab-paclitaxel in aTNBC.Eligible patients [no prior systemic therapy or ≥12 months since (neo)adjuvant chemotherapy] were randomised 2:1 to atezolizumab 840 mg or placebo (days 1, 15), both with paclitaxel 90 mg/m2 (days 1, 8, 15), every 28 days until disease progression or unacceptable toxicity. Stratification factors were tumour PD-L1 status, prior taxane, liver metastases and geographical region. The primary endpoint was investigator-assessed PFS, tested hierarchically first in the PD-L1-positive [immune cell expression ≥1%, VENTANA PD-L1 (SP142) assay] population, and then in the ITT population. OS was a secondary endpoint.Of 651 randomised patients, 45% had PD-L1-positive aTNBC. At the primary PFS analysis, adding atezolizumab to paclitaxel did not improve investigator-assessed PFS in the PD-L1-positive population [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.60-1.12; P = 0.20; median PFS 6.0 months with atezolizumab-paclitaxel versus 5.7 months with placebo-paclitaxel]. In the PD-L1-positive population, atezolizumab-paclitaxel was associated with more favourable unconfirmed best overall response rate (63% versus 55% with placebo-paclitaxel) and median duration of response (7.2 versus 5.5 months, respectively). Final OS results showed no difference between arms (HR 1.11, 95% CI 0.76-1.64; median 22.1 months with atezolizumab-paclitaxel versus 28.3 months with placebo-paclitaxel in the PD-L1-positive population). Results in the ITT population were consistent with the PD-L1-positive population. The safety profile was consistent with known effects of each study drug.Combining atezolizumab with paclitaxel did not improve PFS or OS versus paclitaxel alone. CLINICALTRIALS.GOV: NCT03125902.
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