About this trial

This phase III trial compares the effect of continuation of treatment with pembrolizumab (usual approach) to observation only at preventing cancer from coming back in patients with early-stage triple-negative breast cancer (TNBC) who achieved a pathologic complete response after preoperative chemotherapy in combination with pembrolizumab. The usual approach for patients with early-stage TNBC who receive preoperative chemotherapy plus pembrolizumab is to continue to receive pembrolizumab for up to 27 weeks after surgery. Immunotherapy with monoclonal antibodies, such as pembrolizumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. This trial may help researchers determine if observation is as good as receiving pembrolizumab for 27 weeks after surgery in triple-negative breast cancer patients who achieved a pathologic complete response after preoperative treatment with chemotherapy and pembrolizumab.

Eligibility criteria

Qualifiers

Age >= 18 years

Eastern Cooperative Oncology Group (ECOG) Performance Status 0-2

Patients with a history of clinical stage T1cN1-2 or T2-4N0-2 (clinical stage II or III prior to preoperative therapy) breast cancer at time of diagnosis according to the primary tumor-regional lymph node anatomic staging criteria of the American Joint Committee on Cancer (AJCC), 8th edition as determined by the investigator in radiologic assessment, clinical assessment or both

Patients must have no residual invasive disease in the breast or lymph nodes after the completion of neoadjuvant therapy. Residual ductal carcinoma in situ (DCIS) is allowed. Isolated tumor cells are considered node-negative

Disqualifiers

No stage IV (metastatic) breast cancer

No history of any prior (ipsi- or contralateral) invasive breast cancer. Prior DCIS is allowed

No evidence of recurrent disease following preoperative therapy and surgery

No known active liver disease, e.g. due to hepatitis B virus (HBV), hepatitis C virus (HCV), autoimmune hepatic disorders, or sclerosing cholangitis

Trial design

Treatments tested in this trial

  • Pembrolizumab
  • Patient Observation
  • Biopsy
  • Biospecimen Collection
  • Questionnaire Administration
  • Quality-of-Life Assessment

Treatment groups

1,295 Participants
are divided into 2 treatment groups

Locations

842
Canada
BCCA-Cancer Centre for the Southern InteriorV1Y 5L3, KelownaBritish Columbia, Canada
BCCA-Vancouver Cancer CentreV5Z 4E6, VancouverBritish Columbia, Canada
Atlantic Health Sciences Corporation-Saint John Regional HospitalE2L 4L2, Saint JohnNew Brunswick, Canada
Cambridge Memorial HospitalN1R 3G2, CambridgeOntario, Canada

Sponsors and collaborators

Alliance for Clinical Trials in Oncology

Lead sponsor

National Cancer Institute (NCI)

Collaborator