Clinicopathological evaluation of triple-negative breast cancer treated with keynote-522 regimen

作者：Thaer Khoury, Shipra Gandhi, Gary Tozbikian, Oluwole Fadare, Samira Syed, Briana To, Dionisia Quiroga, Song Yao, Kristopher Attwood, Han Yu, Yisheng Fang · 发表于：The Oncologist · 年份：2025 · DOI：10.1093/oncolo/oyaf231 · 被引用次数：1 · 研究领域：Breast Cancer Treatment Studies、Cancer Immunotherapy and Biomarkers、Multiple and Secondary Primary Cancers

BACKGROUND: Our objective is to compare the response rate between two matched cohorts of early-stage TNBC (chemotherapy: CT + immune checkpoint inhibitor: ICI vs CT alone) and to define clinicopathological variables to identify a subgroup of patients who could be spared or benefit from ICI. METHODS: Patients treated with CT + ICI according to KEYNOTE-522 (KN-522) (n = 128) were included in the study and matched 1:1 with patients treated with CT alone. Matching criteria included age range (10 years), race, clinical stage (c)-AJCC, and histological type (metaplastic [MpBC] vs no special type [IC-NST]). The following histological characteristics in the core needle biopsy (CNB) were included: histological type, Nottingham grade, degree of necrosis, and percentage of tumor-infiltrating lymphocytes (TILs). The residual cancer burden (RCB) was categorized into 0 (pCR), I, II, or III. To identify a subgroup of patients who could be spared or benefit from adding ICI, an analysis of the penalized maximum likelihood estimate was performed. RESULTS: pCR was achieved in 50% of patients treated with CT + ICI vs 35.9% treated with CT alone (P = .02). In the CT group, lower TILs in CNB, non-Black race, MpBC histology, and a higher degree of necrosis were associated with non-pCR. Patients were categorized into quartiles (Q) based on the predicted risk of non-pCR to CT (Q1 represents the lowest risk and Q4 represents the highest risk of non-pCR). In Q4, the pCR rate with CT alone was only 2.9%...