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Replace the toughest part of pre-surgery chemotherapy with an ADC plus immunotherapy, aiming for the same cure rate with less harm.
This idea replaces the anthracycline part of pre-surgery chemotherapy in TNBC with a TROP2 ADC plus pembrolizumab, aiming for the same cure rate with less harm. The KEYNOTE-522 backbone carries cardiac and leukaemia risk from anthracyclines, while ADCs deliver the same chemotherapy class more selectively and ADC-induced immunogenic death complements checkpoint blockade. Sacituzumab govitecan and datopotamab deruxtecan with pembrolizumab already show activity in metastatic disease and in the NeoSTAR and I-SPY 2 arms. The test is a randomised phase 3 against the KEYNOTE-522 regimen with pathologic complete response and then event-free survival endpoints. At early-clinical maturity it bears on the ADC plus checkpoint inhibitor pairing and the SCARLET trial.
Sacituzumab govitecan is a standard second-line or later treatment for metastatic triple-negative breast cancer, roughly doubling survival compared with the chemotherapies it was tested against. Patients should expect neutropenia and diarrhoea, which are manageable with growth factor support and loperamide. Trials are now testing it earlier, in first-line combinations with pembrolizumab and after surgery for residual disease.
This is the paper Europe PMC returns for registry id NCT03036488 with the most citations, so it is the natural first reading for anyone following the KEYNOTE-522 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
This is the paper Europe PMC returns for registry id NCT02819518 with the most citations, so it is the natural first reading for anyone following the KEYNOTE-355 trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
Shares Pembrolizumab for Early Triple-Negative Breast Cancer, Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial, ASCENT: sacituzumab govitecan doubles survival in heavily pretreated metastatic triple-negative breast cancer, KEYNOTE-522.
Shares Pembrolizumab for Early Triple-Negative Breast Cancer, SCARLET (SWOG S2212), KEYNOTE-522, Triple-negative breast cancer (TNBC).
Shares SCARLET (SWOG S2212), KEYNOTE-522, Triple-negative breast cancer (TNBC), Pembrolizumab.
Shares Sacituzumab govitecan, Antibody-drug conjugate (ADC), Pembrolizumab, Immune checkpoint inhibitors.
Shares Sacituzumab govitecan, Antibody-drug conjugate (ADC), Pembrolizumab, Immune checkpoint inhibitors.
Shares Sacituzumab govitecan, Antibody-drug conjugate (ADC), Pembrolizumab, Immune checkpoint inhibitors.
Shares Datopotamab deruxtecan, Sacituzumab govitecan, Antibody-drug conjugate (ADC), Triple-negative breast cancer (TNBC).
Shares ADC + checkpoint inhibitor, ASCENT: sacituzumab govitecan doubles survival in heavily pretreated metastatic triple-negative breast cancer, Sacituzumab govitecan, Antibody-drug conjugate (ADC).