Articles related to IMMUNOTHERAPY

An earlier analysis of this phase 3 trial of neoadjuvant and adjuvant therapy showed that the addition of pembrolizumab to neoadjuvant chemotherapy resulted in a significantly higher percentage of patients with early triple-negative breast cancer having a pathological complete response (defined as no invasive cancer in the breast and negative nodes) at definitive surgery. The trial’s main findings on event-free survival have not been published.

Patients with triple-class-exposed relapsed and refractory multiple myeloma have a dismal prognosis. B-cell maturation antigen-directed chimeric antigen receptor (CAR) T-cell therapy with idecabtagene vicleucel (ide-cel) has previously produced profound, long-lasting responses in individuals with multiple myeloma that has relapsed or become resistant to treatment.

The approval is based on the findings of the DESTINY-Breast04 Phase III trial and follows the Committee for Medicinal Products for Human Use’s favorable recommendation. In the trial, Enhertu (trastuzumab deruxtecan) significantly decreased the risk of disease progression or death in patients with HER2-low metastatic breast cancer with hormone receptor (HR)-positive or HR-negative disease by 50% compared to the physician’s choice of chemotherapy. According to a blinded independent central evaluation, Enhertu had a median progression-free survival (PFS) of 9.9 months compared to chemotherapy patients’ PFS of 5.1 months (BICR). When compared to chemotherapy, Enhertu showed a 36% reduction in the risk of death, with a median overall survival (OS) of 23.4 months as opposed to 16.8 months.

Although immune therapies, such as immune checkpoint inhibitors (ICIs), have significantly improved cancer outcomes, these therapies can also cause off-target tissue damage and response variability. The host microbiome affects ICI responsiveness and risk of immune-related adverse effects (irAEs), according to numerous lines of evidence. These developments show the possibility to control microbiome elements to improve the success of ICI because the microbiome is manipulable.

In conclusion, daratumumab (Darzalex) (D) was added to lenalidomide, bortezomib, and dexamethasone (RVd) in NDMM patients who were transplant-eligible, and this led to enhanced stringent complete response (sCR) and minimal residual disease (MRD)-negative rates, a tolerable safety profile, and no clinically meaningful effects on stem cell mobilization or engraftment. These findings suggest that the D-RVd combination may become a new standard of care for NDMM who are transplant-eligible.

In his discussion of the subject, Adam M. Brufsky, MD, PhD, FACP, of the University of Pittsburgh School of Medicine notes that about 50% of breast cancers categorized as HER2-negative exhibit low HER2 expression, and preliminary data suggest that new antibody-drug conjugates may be effective in treating tumors with low HER2 expression; clinical trials are currently underway. Trastuzumab should not be added to treatment plans for women with low HER2 expression, according to Dr. Brufsky, because it does not assist those with IHC 3+ or ISH-amplified breast cancer or those without those conditions. Finally, compared to triple-negative tumors, hormone receptor-positive (HR+)/HER2-negative cancers seem to have low HER2 expression more commonly.