Atezolizumab and nab-paclitaxel in advanced triple-negative breast cancer

Researchers continue to pursue novel therapies to improve outcomes in patients with unresectable, triple-negative breast cancer. One potential approach entails using nanoparticle albumin-bound (nab)–paclitaxel to bolster the anti-tumor properties of another drug, atezolizumab.

Researchers continue to pursue novel therapies to improve outcomes in patients with unresectable, triple-negative breast cancer. One potential approach entails using nanoparticle albumin-bound (nab)–paclitaxel to bolster the anti-tumor properties of another drug, atezolizumab. To flesh out the theory, investigators recruited about 900 breast cancer patients with untreated metastatic triple-negative disease for a Phase III clinical study. A total of 451 participants were randomized to receive nab-paclitaxel plus atezolizumab, and a like number were assigned to nab-paclitaxel plus placebo. The study identified dual primary outcomes: overall and progression-free survival. At followup a mean 12.9 months after intervention, progression-free survival was a median 7.2 months in the atezolizumab group vs. 5.5 months in the placebo group. Overall survival was a median 21.3 months and 17.6 months, respectively. The benefit of atezolizumab was also observed in a subset of patients with programmed death ligand 1-positive tumors. Those patients had overall and progression-free survival of 25 months and 7.5 months, respectively, compared with 15.5 months and 5 months for patients who received placebo plus nab-paclitaxel. Findings from the IMpassion130 clinical trial indicate that combination therapy with atezolizumab and nab-paclitaxel significantly prolongs progression-free survival in patients with metastatic triple-negative breast cancer without triggering additional safety concerns.