Phase III trial shows new treatment boosts cure rate for most common form of breast cancer (Nivolumab doubles cure rate)

Medical Xpress / Peter MacCallum Cancer Centre / Nature Medicine ^ | Jan. 28, 2025 | Sherene Loi et al

[ConservativeMind]

A clinical trial has shown adding an immunotherapy drug to the chemotherapy that patients receive ahead of surgery can dramatically improve breast cancer cure rates.

The Phase III CheckMate-7FL trial involved 510 people with the "ER+/HER2-"sub-type which accounts for around 70% of all breast cancers. These patients receive chemotherapy to shrink their tumor, making it easier to surgically remove.

This trial assessed adding an infusion of the drug nivolumab—or a placebo—to the pre-surgery phase and then assessing how patients respond overall, and the practice changing results have been published.

Professor Sherene Loi said adding nivolumab led to around a doubling in the number of patients who achieved the best possible outcome known as a pathological complete response (pCR).

"These patients are considered to be likely cured because their tumor was removed and samples of breast and lymph node tissue collected at the same time also show no detectable cancer cells," explains Prof Loi.

"The number of patients who achieved this pCR improved significantly as a result of nivolumab, an exciting result that points to a new treatment paradigm in this most common type of breast cancer."

Overall, pCR rates were 25% in the trial participants treated with nivolumab versus 14% in the placebo group.

In a sub-group of patients with tumors that had the "PD-L1" biomarker—indicating heightened responsiveness to nivolumab—the pCR rate was 44% in the nivolumab group compared to 20% who received the placebo.

PD L1 is a protein known to reduce an immune cell's anti-cancer activity, and nivolumab works by blocking the receptor where PD L1 could bind to an immune cell, so preserving its anti-cancer activity.

There were no new safety signals identified in the trial.

ER+/HER2− breast cancer accounts for 70% of the around 2.3 million cases of breast cancer diagnosed worldwide in 2020.

[ConservativeMind]

Using chemo to shrink and adding nivolumab (a monoclonal antibody) before having surgery reduced the tumor and doubled the cure rate from standard practice.

From other things I’ve read and posted, having a live cancer target for the monoclonal antibodies appears more helpful than administering this later, when there’s little left for it to see.

[ConservativeMind]

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[MayflowerMadam]

At my church book club I heard about a friend who was at the end of life with breast cancer. Basically no hope.

As a last resort they gave her the T-cell treatment and she improved quickly. That was 27 years ago, and she has not had a recurrence.

I’m familiar with the procedure because in January it was used successfully (so far) on my relative to treat his cancer.

I don’t know why we don’t hear about it often. Usually only chemo and radiation.