Dr. Burris on Recent Advances in TNBC

Howard A. “Skip” Burris, III, MD, FASCO, FACP, chief medical officer and president of Clinical Operations at Sarah Cannon Research Institute, and a 2014 Giant of Cancer Care® in Drug Development, discusses recent advancements made in the field of triple-negative breast cancer (TNBC).

In the field of TNBC, significant advances have been made; they focus on 3 paradigms that have become attractive for the treatment of patients with cancer, according to Burris: immunotherapy, targeted biologics, and antibody-drug conjugates (ADCs).

In terms of targeted biologics, PARP inhibitors target specific mutational profiles. Additionally, ADCs were designed to deliver chemotherapy via an antibody, otherwise known as the “smart bomb” approach; this entails targeting the tumor, minimizing collateral damage, and more effectively delivering a toxin to the cells to achieve cell death, explains Burris. Now, sacituzumab govitecan (Trodelvy) has become the first FDA-approved ADC for use in patients with TNBC; this agent has generated excitement and holds a lot of promise, according to Burris.

Many patients with early-stage TNBC would benefit from neoadjuvant therapy as the majority will not receive hormonal therapy or HER2-based therapy; they are candidates for chemotherapy. Evaluating different neoadjuvant and adjuvant strategies remains the focus of several clinical trial efforts, says Burris. With regard to neoadjuvant therapy, the addition of checkpoint inhibitors—specifically immunotherapy with chemotherapy—have generated promising results.

Specifically, the addition of pembrolizumab (Keytruda) is being explored in this setting and this approach has resulted in deep responses, notes Burris. Pathological complete response, in particular, is the current standard. However, longer follow-up is needed to examine the overall benefits of this approach and whether these patients might require further treatment, concludes Burris.