A newly-approved option for TNBC MBC patients whose tumors are PD-L1 positive is the combination of Pembrolizumab (Keytruda) and chemotherapy. This combination was based upon the KEYNOTE-355 trial which randomized TNBC MBC patients who had not previously taken chemotherapy in the metastatic setting to receive either Keytruda plus chemotherapy or chemotherapy alone. The median PFS was 9.7 months for patients taking the combination vs. 5.6 months for patients taking chemotherapy only. A test called PD-L1 IHC 22C3 pharmDx has been FDA-approved as a companion diagnostic for selecting patients with TNBC to be eligible for the Keytruda plus chemotherapy regimen. From: fda.gov/drugs/drug-approval...
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Bestbird
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Bestbird - Thanks for sharing this valuable info! I'm passing it along to my sis, who has TN MBC, although it sounds like a trial she was considered for but didn't qualify for due to some other "negative" traits of her cancer...She said that she's "quintuple negative" (her phrase, not the doc's ).
Lynn, if your sister's tumor does not express PD-L1, she can still take Trodelvy(Sacituzumab Govitecan) down line . "Third- or later-line therapy for TNBC patients should be Trodelvy (which was FDA-approved in April 2020 for the treatment of adult TNBC MBC patients who have received at least two prior therapies for their metastatic disease.) Trodelvy, which is administered intravenously, consists of the chemotherapy drug irinotecan linked with an antibody targeted against TROP-2, a cell-surface protein that is expressed in more than 90% of TNBC." It's a very effective drug for many, and I hope your sister does well on it!
Also, it's possible that your sister's TNBC is Androgen Receptor (AR) positive, which would not be unusual. If it's positive, there may be a clinical trial. The AR testing can be done on her prior biopsy in the same way that HR receptivity is measured.
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