The KEYNOTE-522 trial, published in May 2024, highlights how pembrolizumab combined with chemotherapy improves event-free survival (EFS) in early-stage triple-negative breast cancer (TNBC), particularly across Residual Cancer Burden (RCB) categories. Pembrolizumab led to a shift toward lower RCB categories, with fewer patients in RCB-1, RCB-2, and RCB-3 compared to the placebo group. The greatest EFS benefit was seen in RCB-2 patients (HR 0.52, 95% CI: 0.32-0.82). While distant recurrences were the most common first EFS event, pembrolizumab reduced them across all RCB groups.
These findings reinforce that pembrolizumab’s benefits extend beyond pathologic complete response (pCR), improving long-term outcomes even in patients with residual disease. Led by Dr. Lajos Pusztai and his team, this research continues to refine immunotherapy’s role in early-stage TNBC.
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