Adding an immune checkpoint inhibitor to a standard chemotherapy regimen for patients with early-stage triple-negative breast cancer did not affect patients’ ability to perform day-to-day activities more than treatment with chemotherapy alone, according to research presented by Elizabeth Mittendorf, MD, PhD, and colleagues at the 2020 San Antonio Breast Cancer Symposium (Abstract GS3-02).
Elizabeth Mittendorf, MD, PhD
The report, coupled with earlier findings that combining checkpoint inhibitors with chemotherapy can increase response rates in patients with early-stage triple-negative breast cancer, offer assurance that the benefits of the combination can be achieved without diminishing patients’ quality of life, the study authors said. The study is the first to use patients’ own feedback to gauge the impact of the combination therapy on daily functioning for patients with early-stage breast cancer.
IMpassion031
The analysis is based on data from the IMpassion031 study, a phase III trial of the safety and effectiveness of the checkpoint inhibitor atezolizumab in tandem with standard chemotherapy prior to surgery in 333 patients with previously untreated triple-negative breast cancer. Atezolizumab works by blocking the PD-L1 protein on tumor cells.
Patients participating in the IMpassion031 trial were randomly assigned to receive either atezolizumab plus nab-paclitaxel, doxorubicin, and cyclophosphamide or the same chemotherapy agents plus a placebo, prior to undergoing breast cancer surgery. Their response to treatment was assessed at the time of surgery.
Researchers reported earlier this year that the combination therapy increased the likelihood that patients with early-stage triple-negative breast cancer would have a complete response.
Performing Daily Tasks
This new study explored whether that improvement was accompanied by a decline in patients’ performance of daily tasks. Trial participants were asked to rate their ability to carry out everyday activities, such as going to work and preparing meals, in the months following treatment. Although participants reported increased difficulty in these areas—as a result of treatment side effects such as nausea, diarrhea, and fatigue—there were no differences reported between patients who received the combination therapy and those who received chemotherapy alone. As the side effects diminished over time, patients in both groups rebounded equally well.
“Treatment for early-stage breast cancer aims to be curative,” said Dr. Mittendorf, Director of the Breast Immuno-Oncology Program at the Dana-Farber/Brigham and Women’s Cancer Center. “In such cases, we want to be sure that improvements in outcomes are balanced against effects on patients’ quality of life. Our findings suggest that the combination of checkpoint inhibitors and chemotherapy meets that test.”
