New Combination Therapy Shows Promise for Advanced Triple-Negative Breast Cancer

Recent clinical trial findings from Dana-Farber Cancer Institute reveal that combining the antibody-drug conjugate sacituzumab govitecan with the immune checkpoint inhibitor pembrolizumab significantly outperforms standard chemotherapy approaches in treating advanced triple-negative breast cancer (TNBC) that is PD-L1 positive. The phase 3 ASCENT-04 study, which evaluated first-line treatment options for patients with metastatic TNBC, enrolled 443 participants and compared outcomes between those receiving the combination therapy versus chemotherapy with pembrolizumab.

Patients treated with sacituzumab govitecan plus pembrolizumab demonstrated a median progression-free survival of 11.2 months, substantially longer than the 7.8 months observed in the chemotherapy plus pembrolizumab group. Response rates were also notable, with nearly 60% of patients responding to the antibody-drug combination, and responses lasting a median of 16.6 months compared to 9.2 months for the standard treatment. Although overall survival data are still maturing, early indications favor the new combination.

This therapy leverages sacituzumab govitecan’s ability to target TROP-2 proteins on cancer cells, delivering cytotoxic drugs directly to tumors, while pembrolizumab enhances the immune response against cancer cells. Currently approved for later-line treatments, this study suggests that moving these targeted therapies into the first-line setting could drastically improve patient outcomes.

Triple-negative breast cancer is known for its aggressive nature and lack of hormone receptors, posing significant treatment challenges. Historically, the five-year survival rate for metastatic cases remains around 12%. The promising results from this trial could reshape clinical practice and offer new hope for patients with PD-L1-positive TNBC.

Dana-Farber’s involvement in the development and testing of sacituzumab govitecan underscores its commitment to advancing breast cancer treatments. The study’s findings, which will be submitted to regulatory agencies, aim to pave the way for broader use of this combination as an initial therapy in suitable patients, potentially transforming the treatment landscape for this difficult-to-treat cancer.