Extending Survival for Patients With TNBC: Are You Up to Date on New Treatment Standards?
False. Although the immune system plays little role in breast cancer tumorigenesis overall, triple negative breast cancer (TNBC) is an “inflamed” breast cancer subtype. One immune checkpoint inhibitor (ICI) has been approved—and several more are in clinical development—for the treatment of TNBC.(1-3) The integration of ICIs into treatment strategies for TNBC can be challenging, especially for those delivering care within the VA system, where women represent an unusually small proportion (3%) of cancer diagnoses.(4)
Click the “Continue” button to learn more about the role of ICIs in the clinical management of early stage and metastatic TNBC.
- Denkert C, et al. Lancet. 2017;389:2430-2442.
- Nathan MR, et al. Breast. 2018;37:200-206.
- Li Z, et al. J Transl Med. 2018;16:147.
- Colonna S, et al. Med Care. 2015;53:S149-55.
Kevin Kalinsky, MD, MS
Associate Professor of Medicine
Herbert Irving Comprehensive Cancer Center
New York-Presbyterian Hospital/Columbia University
Irving Medical Center
New York, NY
Erin Mooney, MS
Clinical Content Manager
Lisa R. Rinehart, MS, ELS
Director, Editorial Services
Kathryn Schaefer, MSN, RN, CPHRM
Senior Manager, Accreditation and Compliance
East Lansing, MI
Jennifer Gregg, PhD
Cranberry Township, PA
Upon completion, participants should be able to:
- Evaluate clinically relevant data on ICIs for early stage and metastatic TNBC
- Identify patients with TNBC who may benefit from treatment with ICIs and/or be eligible for enrollment in clinical trials
- Monitor patients receiving ICIs to assess treatment response and manage irAEs
This activity is intended for physicians, nurses, pharmacists, and other providers who manage the health of beneficiaries in the federal healthcare system.
Statement of Need
Healthcare professionals who work within the federal healthcare system manage approximately 50,000 incident cancer diagnoses each year. Of these cases, approximately 0.8% represent women with breast cancer, and an even smaller proportion of these involve the most aggressive breast cancer subtype, triple negative breast cancer (TNBC). Although TNBC is a rarely seen cancer in the federal healthcare system, it is important that clinicians be able to optimally manage it when it does present, especially given the emerging, life-extending treatment advances. In early 2019, the FDA approved the combination of atezolizumab and nab-paclitaxel as first-line therapy for women with recurrent or metastatic TNBC positive for programmed cell death ligand 1 (PD-L1) expression. Shortly thereafter, guideline recommendations for TNBC were updated to include this combination regimen as the preferred regimen in this disease and treatment setting. To apply these treatment advances to practice, providers in the federal healthcare system must be able to assess tumor PD-L1 expression to select patients for immunotherapy as well as be able to support those receiving this treatment. Additionally, providers must understand the monitoring and management practices required to properly assess response and identify and manage potential treatment-emergent, immune-related adverse events.
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Initial Release Date: August 2, 2019
Expiration Date: August 1, 2020
Estimated Time to Complete This Activity: 1 hour
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Kevin Kalinsky, MD, MS
Salary (spouse): Array BioPharma
Consulting fees/advisory boards: Amgen Inc, Biotheranostics, Eisai Inc., Eli Lilly and Corporation, Genentech, Immunomedics, Ipsen Group, Novartis Pharmaceutical Corporation, Pfizer Inc.
Ownership interest (spouse): Array BioPharma
Other (speakers bureau): Eli Lilly and Corporation
The writer, peer reviewers, and activity planners have no financial relationships to disclose.
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