It is one of the first treatments other than traditional treatments (chemotherapy) against triple negative breast cancer. A study has just shown that it reduced the risk of death by more than 34%. A revolution in which the Jean-Perrin center in Clermont-Ferrand participated.
Pink October is breast cancer month. And research is one of its best weapons. Research against triple negative breast cancer has just taken a further step with the latest results of the international Keynote 522 study which included more than 1,174 patients between 2017 and 2018. Oncologist Marie-Ange Mouret-Reynier, head of the department of oncology at the Jean-Perrin center, explains why this new treatment is revolutionary.
What is this triple negative cancer?
It is a type of breast cancer that does not have hormone receptors, meaning it does not respond to anti-hormonal cancer treatments. Around 70% of breast cancers are in fact sensitive to hormones. The triple negative therefore has no receptors for either estrogen or progesterone and the HER2 receptor is not expressed either. No possible treatments targeted at these three receptors. The only possible treatment until then was chemotherapy.
Was the chemotherapy effective?
Yes, but we had a proportion of triple negative cancers which responded very poorly. These are often very aggressive and very proliferative tumors, evolving very quickly. Chemotherapy alone did not sufficiently control the disease.
Incidence. Each year, 61,000 new cases of breast cancer develop in France, 15% of which are triple negative, or around 9,000 women affected.
For several years, the Jean-Perrin center has been researching this triple negative cancer. Where are these studies today?
Yes, the Jean-Perrin center was a pioneer, particularly in neoadjuvant treatments and preoperative care. In the Keynote 522 study, it was the largest includer of patients in France to test chemotherapy and immunotherapy treatment before surgery. We obtained the first results in 2019. And the latest results have just been presented at a European congress.
Molecules against certain cancers soon to be tested at the Clermont-Ferrand University Hospital
How effective is this treatment?
Concerning the preoperative response, this treatment, Penbrolizumab, stimulates the patient’s immune system and promotes the destruction of tumor cells, already induced by chemotherapy. In 2019, the first results showed that if we combined this treatment with chemotherapy, we no longer found a tumor in 65% of cases, versus 51% with chemotherapy alone. Concerning survival without relapse: at 5 years, 84.5% of patients are alive without relapse; compared to 76% without immunotherapy. The improvement delta is therefore very important. In September 2024, we had the overall survival results, still at 5 years, it is 86.6% with treatment (compared to 81.7% without immunotherapy).
Does this give a lot of hope?
The results are very significant because they mean that we have a reduction in the risk of death of 34%. Which makes this treatment a standard. It is now accessible to all women. It has been in early access since March 2022. It concerns triple negative cancers at risk (large tumors, or tumor with lymph node involvement). Around 7,000 patients were treated throughout France.
Michele Gardette
[email protected]
An innovative therapy against cancers, including prostate cancer, at the Jean-Perrin Center in Clermont-Ferrand
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