Affiliations 

  • 1 Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
  • 2 Barts Cancer Institute, Centre for Experimental Cancer Medicine, London, UK
  • 3 Department of Medicine, University of California San Francisco Comprehensive Cancer Center, San Francisco, CA, USA
  • 4 Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
  • 5 Cancer Center, Pantai Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 6 Oncology Institute, Arturo Lopez Perez Foundation, Santiago, Chile
  • 7 Department of Oncology, Republican Clinical Oncology Dispensary, Republic of Bashkortostan, Ufa, Russian Federation
  • 8 Oncology Research Unit, Hospital São Lucas, PUCRS, Porto Alegre, Brazil
  • 9 International Breast Cancer Center, Pangaea Oncology, Quirónsalud Group, Barcelona, and Medica Scientia Innovation Research (MEDSIR), Barcelona, Spain and Ridgewood, NJ, USA
  • 10 Department of Breast Oncology, Aichi Cancer Center Hospital, Japan
  • 11 Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • 12 Department of Hematology and Oncology, Oncomedica S.A.S, Monteria, Colombia
  • 13 Department of Internal Medicine, Ege University Medical Faculty, Izmir, Turkey
  • 14 Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia, and the Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
  • 15 Merck & Co., Inc., Rahway, NJ, USA
  • 16 International Breast Cancer Center (IBCC), Pangaea Oncology, Quiron Group, Madrid and Barcelona, Spain; Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Department of Medicine, Madrid, Spain
J Natl Cancer Inst, 2023 Dec 09.
PMID: 38070159 DOI: 10.1093/jnci/djad240

Abstract

BACKGROUND: In KEYNOTE-355 (NCT02819518), addition of pembrolizumab to chemotherapy led to statistically significant improvements in progression-free survival and overall survival in patients with advanced triple-negative breast cancer (TNBC) with tumor PD-L1 combined positive score (CPS) ≥10. We report patient-reported outcomes (PROs) from KEYNOTE-355.

METHODS: Patients were randomized 2:1 to pembrolizumab 200 mg or placebo every 3 weeks for up to 35 cycles plus investigator's choice chemotherapy (nab-paclitaxel, paclitaxel, or gemcitabine/carboplatin). QLQ-C30, QLQ-BR23, and EQ-5D visual analogue scale (VAS) were prespecified. PROs were analyzed for patients who received ≥1 dose of study treatment and completed ≥1 PRO assessment. Change in PRO scores from baseline were assessed at week 15 (latest time point at which completion/compliance rates were ≥60%/≥80%). Time to deterioration (TTD) in PROs was defined as time to first onset of ≥ 10-point worsening in score from baseline.

RESULTS: PRO analyses included 317 patients with tumor PD-L1 CPS ≥10 (pembrolizumab plus chemotherapy; n = 217; placebo plus chemotherapy, n = 100). There were no between-group differences in change from baseline to week 15 in QLQ-C30 global health status/quality of life (GHS/QoL; least-squares mean difference, -1.81 [95% CI, -6.92 to 3.30]), emotional functioning (-1.43 [-7.03 to 4.16]), physical functioning (-1.05 [-6.59 to 4.50]), or EQ-5D VAS (0.18 [-5.04 to 5.39]), and no between-group difference in TTD in QLQ-C30 GHS/QoL, emotional functioning, or physical functioning.

CONCLUSIONS: Together with the efficacy and safety findings, PRO results from KEYNOTE-355 support pembrolizumab plus chemotherapy as a standard of care for patients with advanced TNBC with tumor PD-L1 (CPS ≥10).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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