Content provided by Virginia Oncology Associates (VOA)
Clinical trials at Virginia Oncology Associates (VOA) are offering new hope to patients with all stages of triple-negative breast cancer (TNBC). TNBC, an aggressive and invasive disease subtype, makes up about 15 percent of breast cancers. More common in younger and/or Black women, the illness does not respond to either hormone therapy or older drugs that target the HER2 protein on tumors. “These emerging treatments have the power to improve outcomes in many diverse patient groups,” said Michael A. Danso, MD, a Medical Oncologist, Hematologist and Research Director at VOA. “We’re always trying to do even better than the latest standard of care.”
Historically, TNBC patients have relied on chemotherapy alone. Then in 2017, the nationwide Keynote-355 trial looked at adding the immunotherapy drug pembrolizumab (Keytruda) to standard chemotherapy for locally recurrent, unresectable or advanced TNBC. The trial found the combination therapy significantly improved progression-free survival by targeting the PD-L1 protein, which helps some cancer cells avoid immune system detection. In 2020, the FDA granted accelerated approval for the studied patient group.
Next came Keynote-522, which evaluated the same approach for early-stage TNBC. Data showed a 34 percent reduced risk of death, with notable improvements in event-free survival and pathological complete response; FDA approval followed in 2021.
Today, one focus is antibody drug conjugates (ADCs) that bind to surface proteins on cancer cells and release a chemotherapy agent. One study, ASCENT, compared using sacituzumab govitecan (Trodelvy) to seek out the Trop-2 protein–overexpressed in many cancer cells–to chemotherapy alone in metastatic patients who hadn’t responded to first-line therapies. Again, results were striking: median survival was 12.1 months for combination therapy patients, for example, versus 6.7 months for the chemotherapy-only group. The FDA approved Trodelvy as a second-line treatment in 2023; the drug is now in trials as a potential first-line therapy.
Another study, BEGONIA, is investigating the combination of datopotamab deruxtecan (Dato-DXd)–an ADC that also targets Trop-2 proteins–and durvalumab (Imfinzi), an immunotherapy drug that binds to PD-L1. “It looks incredibly effective in initial trials,” Dr. Danso said. “Nearly 80 percent of metastatic patients showed a confirmed objective response rate.” Researchers are testing the therapy in early-stage patients as well.
VOA’s participation in such pioneering work is just a small snapshot into its robust research program, Dr. Danso noted, “Our patients deserve nothing less than the best.”
For more information, visit virginiacancer.com.