Editor's Note: The 2024 European Society for Medical Oncology (ESMO) Annual Meeting is taking place from September 13-17 in Barcelona, Spain. Dr. Tao Sun from Liaoning Cancer Hospital is leading a prospective phase II study, which will be presented as a poster at the conference (Poster Abstract No. 387P). This study explores the efficacy and safety of the combination of anlotinib, penpulimab, and nab-paclitaxel as first-line treatment for advanced triple-negative breast cancer (TNBC). The interim results demonstrate the significant advantages of this combination in terms of objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS), while also confirming its favorable safety and tolerability. As the research progresses, we anticipate that this innovative therapy could further extend patient survival and improve quality of life, offering hope to more TNBC patients.Effectiveness and Safety of the Combination of Anlotinib, Penpulimab, and Nab-Paclitaxel in First-Line Treatment of Advanced TNBC
Dr. Tao Sun: The success of this study can largely be attributed to the chosen regimen—a combination of targeted therapy, immunotherapy, and chemotherapy—that exhibits synergistic anti-tumor effects.
Penpulimab is a PD-1 antibody that blocks the interaction between PD-1 and PD-L1/2, preventing immune evasion by tumor cells. Compared to traditional paclitaxel, nab-paclitaxel binds to albumin during delivery, enhancing the drug’s solubility in the bloodstream and allowing for greater accumulation in tumor tissues through the enhanced permeability and retention (EPR) effect, which leads to more effective tumor cell destruction.
Previous studies have shown that nab-paclitaxel can modulate immune system activity, enhancing the patient’s immune response to tumors, thereby positively influencing the treatment of TNBC. For instance, the IMpassion130 study, which combined immunotherapy with nab-paclitaxel, demonstrated clear overall survival (OS) benefits, whereas the IMpassion131 study, which used paclitaxel, yielded negative results. This suggests that not all chemotherapy drugs are suitable for combination with immunotherapy. Based on these findings, we selected nab-paclitaxel as the chemotherapy component in this immunotherapy combination.
Anlotinib is a novel multi-target tyrosine kinase inhibitor (TKI) that targets VEGFR, PDGFR, FGFR, and c-Kit, inhibiting tumor angiogenesis and tumor growth.
The current results of this study indicate that the triple combination of anlotinib, penpulimab, and nab-paclitaxel has demonstrated strong anti-tumor activity and safety as a first-line treatment for TNBC. This provides new evidence supporting the application of immunotherapy in the first-line treatment of TNBC. Notably, in previous studies exploring immunotherapy combined with chemotherapy for TNBC, significant therapeutic benefits were generally observed only in patients with PD-L1-positive expression. In the next stage, we plan to further analyze the efficacy of this combination in PD-L1-negative patients. Additionally, we will explore related genomic biomarkers to provide more precise treatment options for advanced TNBC patients in China.
Dr. Tao Sun Director, Department of Breast Oncology, Liaoning Cancer Hospital PhD Supervisor, Expert with Special Government Allowance of the State Council, Professor (Second Tier) Renowned Young Physician in Liaoning Standing Committee Member, Breast Cancer Professional Committee, Chinese Society of Clinical Oncology (CSCO) Vice Chairman, Cardio-Oncology Professional Committee, CSCO Vice Chairman, Tumor Heterogeneity and Personalized Treatment Committee, Chinese Anti-Cancer Association Vice Chairman, Tumor Markers Committee, Chinese Anti-Cancer Association Standing Committee Member, Targeted Therapy Professional Committee, Chinese Anti-Cancer Association Standing Committee Member, Multiple and Unknown Primary Tumors Committee, Chinese Anti-Cancer Association Vice Chairman, Breast Disease Professional Committee, China Medical Education Association Vice Chairman, Precision Medicine and Oncology MDT Professional Committee, Chinese Research Hospital Association Chairman, Tumor Markers Committee, Liaoning Anti-Cancer Association Chairman-Elect, Chemotherapy Committee, Liaoning Anti-Cancer Association Chairman, Anti-Tumor Drugs Committee, Liaoning Pharmaceutical Association Vice Chairman, Clinical Evaluation of Pharmaceutical Drugs Professional Committee, Liaoning Pharmaceutical Association
