Meta- analysis of long-term outcomes of addition of immunotherapy to neoadjuvant chemotherapy for early-stage triple-negative breast cancer

Randomized controlled trials (RCTs) showed that addition of immunotherapy to neoadjuvant chemotherapy for stage II or III triple-negative breast cancer (TNBC) was associated with improved pathological complete response rates, but additional evidence of long-term outcomes is warranted. Individual patient data level meta-analysis of four RCTs (KEYNOTE-522, IMpassion031, I-SPY2, and GeparNuevo) found that addition of immunotherapy to neoadjuvant chemotherapy for early-stage TNBC was associated with significantly improved event-free survival (HR 0.62; p<0.001) and overall survival (HR. 0.62; p<0.001). Number needed to treat to avoid one EFS or OS event in four year was 9 and 14, respectively. Trial-level meta-analysis yielded similar results. The authors conclude that addition of immunotherapy to neoadjuvant chemotherapy for early-stage TNBC was associated with improved survival outcomes.