We urgently need better biomarkers to identify responders vs nonresponders and select the right drug for the right patient.

— Aditya Bardia, MD, MPH

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Commenting on the phase I study of atezolizumab (Tecentriq) presented at the 2017 American Association for Cancer Research Annual Meeting, Aditya Bardia, MD, MPH, Attending Physician at Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, said: “It is very encouraging to see that patients who responded really did well. When it works, it really works and is like a home run…. All responders had 100% progression-free survival at 1 year. Duration of response was 20 months.”

But only about 10% of the triple-negative breast cancer cohort responded. “For them, this is good news, but for the majority of patients, even those with PD-L1 positive tumors, the results were not so good. The response rate did not vary much by PD-L1 expression (≥ 5% cut-off) and we urgently need better biomarkers to identify responders vs nonresponders and select the right drug for the right patient,” he emphasized.

A limitation of the study is that it is a single-arm phase I trial. The phase III IMpassion 130 trial will compare nab-paclitaxel (Abraxane) plus atezolizumab vs nab-paclitaxel alone. “If this study is positive, it will probably lead to approval for atezolizumab in triple-negative breast cancer,” he said. ■

Disclosure: Dr. Bardia is a consultant and on the advisory board and steering committee for Novartis, Genentech, and Pfizer.