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Toripalimab plus nab-paclitaxel in metastatic or recurrent triple-negative breast cancer: a randomized phase 3 trial

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机构: [1]Fifth Med Ctr Chinese PLA Gen Hosp, Beijing, Peoples R China [2]Cent South Univ, Affiliated Canc Hosp, Dept Internal Med Breast, Xiangya Sch Med, Changsha, Peoples R China [3]China Med Univ, Liaoning Canc Hosp, Dept Breast Med, Canc Hosp, Shenyang 110042, Peoples R China [4]Harbin Med Univ, Canc Hosp, Dept Breast Surg, Harbin, Peoples R China [5]First Hosp China Med Univ, Dept Med Oncol, Shenyang, Peoples R China [6]First Hosp Jilin Univ, Neurosci Ctr, Changchun, Peoples R China [7]Qingdao Univ, Breast Dis Ctr, Affiliated Hosp, Qingdao, Shandong, Peoples R China [8]Jiangsu Prov Hosp, Dept Oncol, Nanjing, Peoples R China [9]Zhejiang Canc Hosp, Dept Breast Canc Surg, Hangzhou, Zhejiang, Peoples R China [10]Chongqing Univ, Canc Hosp, Breast Canc Ctr, Chongqing, Peoples R China [11]Shanxian Hygeia Hosp, Breast Dept, Jinan, Shandong, Peoples R China [12]XinJiang Med Univ, Affiliated Canc Hosp, Breast Internal Med Dept, Affiliated Teaching Hosp 3, Urumqi 830011, Peoples R China [13]Linyi Canc Hosp, Dept Breast Surg, Linyi, Peoples R China [14]Jiangsu Canc Hosp, Dept Oncol, Nanjing, Peoples R China [15]First Affiliated Hosp Xian Jiaotong Univ, Dept Med Oncol, Xian 710061, Peoples R China [16]First Affiliated Hosp, Bengbu Med Coll, Dept Oncol Surg, Bengbu, Peoples R China [17]Henan Canc Hosp, Dept Breast Surg, Zhengzhou 450008, Henan, Peoples R China [18]Ningxia Med Univ, Gen Hosp, Dept Med Oncol, Yinchuan, Peoples R China [19]Xiangyang Cent Hosp, Dept Oncol, Xiangyang 441021, Peoples R China [20]Jilin Canc Hosp, Dept Med Oncol, Changchun, Peoples R China [21]Second Hosp Dalian Med Univ, Dept Intervent Oncol, Dalian, Peoples R China [22]Affiliated Hosp Hebei Univ, Dept Med Oncol, Baoding 071000, Peoples R China [23]Sun Yat Sen Univ, Canc Ctr, Dept Internal Med 2, Guangzhou, Peoples R China [24]Fujian Med Univ, Union Hosp, Dept Breast Surg, Fuzhou, Peoples R China [25]Hubei Canc Hosp, Dept Radiol, Wuhan, Peoples R China [26]HUST, Dept Orthopaed, Union Hosp, Tongji Med Coll, Wuhan, Hubei, Peoples R China [27]Sichuan Canc Hosp, Dept Breast Surg, Chengdu, Sichuan, Peoples R China [28]Sun Yat Sen Univ, Affiliated Hosp 1, Dept Breast Surg, Guangzhou 510080, Peoples R China [29]Fourth Hosp Hebei Med Univ, Breast Ctr Dept, Shijiazhuang, Peoples R China [30]First Affiliated Hosp Anhui Med Univ, Dept Radiat Oncol, Hefei, Peoples R China [31]Nanchang Third Hosp, Dept Breast Surg, Nanchang 330000, Peoples R China [32]HUST, Tongji Med Coll, Tongji Hosp, Dept Oncol, Wuhan, Peoples R China [33]Jiangnan Univ, Affiliated Hosp, Dept Oncol, Wuxi, Peoples R China [34]Chinese Peoples Liberat Army Gen Hosp, First Med Ctr, Dept Med Oncol, Beijing 100853, Peoples R China [35]Chengde Med Univ, Dept Oncol, Affiliated Hosp, Chengde, Peoples R China [36]Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Breast Surg, Hangzhou 310009, Peoples R China [37]Second Affiliated Hosp Anhui Med Univ, Dept Oncol, Hefei, Anhui, Peoples R China [38]Guangzhou Panyu Cent Hosp, Dept Thyroid & Breast Surg, Guangzhou, Peoples R China [39]Beijing Hosp, Dept Med Oncol, Beijing, Peoples R China [40]Jiangxi Canc Hosp, Dept Breast Canc Surg, Nanchang, Peoples R China [41]Kunming Med Univ, Yunnan Canc Hosp, Dept Breast Surg 3, Affiliated Hosp 3, Kunming 650118, Yunnan, Peoples R China [42]Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Breast Surg, Guangzhou 510120, Peoples R China [43]Guangzhou First People Hosp, Dept Breast Oncol, Guangzhou, Guangdong, Peoples R China [44]Peking Univ, Shougang Hosp, Dept Breast Dis, Beijing, Peoples R China [45]First Affiliated Hosp Xiamen Univ, Dept Pediat, Xiamen, Peoples R China [46]First Affiliated Hosp USTC, Anhui Prov Hosp, Dept Hematol, Hefei 230001, Peoples R China [47]Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Breast Surg, Hangzhou, Peoples R China [48]Peoples Liberat Army Air Force Med Univ, Affiliated Hosp 2, Dept Infect Dis, Xian, Shaanxi, Peoples R China [49]First Peoples Hosp Foshan, Dept Breast Surg, Foshan, Peoples R China [50]Tongji Univ, Peoples Hosp Shanghai 10, Dept Thyroid & Breast Surg, Shanghai 200072, Peoples R China [51]Southwest Med Univ, Affiliated Hosp, Dept Oncol, Luzhou, Peoples R China [52]Shanghai Zhabei Dist Shibei Hosp, Dept Oncol, Shanghai, Peoples R China [53]Fudan Univ, Shanghai Canc Ctr, Shanghai, Peoples R China [54]Henan Prov Peoples Hosp, Dept Med Oncol, Zhengzhou, Peoples R China [55]Shanghai Junshi Biosci, Shanghai, Peoples R China [56]TopAlliance Biosci, Rockville, MD USA
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The combination of immune-checkpoint blockade with chemotherapy for the first-line treatment of advanced triple-negative breast cancer (TNBC) has generated mixed results. TORCHLIGHT is a randomized, double-blinded phase 3 trial evaluating the efficacy and safety of first-line toripalimab and nab-paclitaxel (nab-P) (n = 353; experimental arm) versus placebo and nab-P (n = 178; control arm) for the treatment of women with metastatic or recurrent TNBC. The primary end point was progression-free survival (PFS) assessed by a blinded independent central review in the PD-L1-positive and intention-to-treat populations. The secondary end points included overall survival and safety. Overall, 200 and 100 patients, in the toripalimab and placebo arm respectively had PD-L1-positive TNBC. At the prespecified interim analysis, a statistically significant improvement in PFS assessed by a blinded independent central review was demonstrated in the experimental arm in the PD-L1-positive population (median PFS 8.4 versus 5.6 months; hazard ratio (HR) = 0.65, 95% confidence interval (CI) 0.470-0.906, P = 0.0102). The median overall survival was 32.8 versus 19.5 months (HR = 0.62, 95% CI 0.414-0.914, P = 0.0148). Similar incidences of treatment-emergent adverse events (AEs) (99.2% versus 98.9%), grade >= 3 treatment-emergent AEs (56.4% versus 54.3%) and fatal AEs (0.6% versus 3.4%) occurred in the experimental and control arms. The addition of toripalimab to nab-P provided a significant improvement in PFS for PD-L1-positive patients with metastatic or recurrent TNBC with an acceptable safety profile. ClinicalTrial.gov identifier NCT03777579. In this prespecified analysis of the ongoing TORCHLIGHT phase 3 trial, first-line treatment with toripalimab and nab-paclitaxel in patients with advanced triple-negative breast cancer led to significantly longer progression-free survival in the PD-L1-positive population compared to nab-paclitaxel alone.

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大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 细胞生物学 1 区 医学:研究与实验
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Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Q1 CELL BIOLOGY Q1 MEDICINE, RESEARCH & EXPERIMENTAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2023版]

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第一作者机构: [1]Fifth Med Ctr Chinese PLA Gen Hosp, Beijing, Peoples R China
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