Predictors of pathologic complete response in early-stage triple-negative breast cancer treated with neoadjuvant chemo-immunotherapy: a multi-institution study.
Diabetes appears to reduce treatment response in triple-negative breast cancer, suggesting metabolism-focused interventions might improve outcomes with immunotherapy.
In 374 diverse real-world TNBC patients receiving KEYNOTE-522-style neoadjuvant pembrolizumab plus chemotherapy, the overall pCR rate was 61.2%, consistent with trial data; diabetes independently predicted lower pCR on multivariate analysis, highlighting a potentially modifiable resistance mechanism. The study validates KEYNOTE-522 generalizability and identifies an actionable co-morbidity that may warrant prospective evaluation of metabolic intervention alongside chemo-immunotherapy.
What the study was
- Study design
- Retrospective multicenter cohort
- Population
- Early-stage TNBC patients, diverse real-world cohort (29.1% non-White, 48.4% BMI ≥30), 3 US hospital systems, 2021-2023
- Sample size
- 374
- Category
- Treatment Innovation
- Maturity
- Validated
- Journal
- Breast Cancer Res Treat
Why it surfaced
HIGH by NOVEL_TREATMENT flag. Real-world multicenter validation of KEYNOTE-522 pembro regimen in diverse population (29% non-White, 48% obese); diabetes-pCR finding is novel hypothesis-generating. Retrospective design limits but n=374 is substantial.
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