Michail Ignatiadis: The final analysis of the ALEXANDRA/IMpassion030 trial
Michail Ignatiadis, Jules Bordet Institute, posted on X about recent paper he co-authored with colleagues, titled “Adjuvant Atezolizumab for Early Triple-Negative Breast Cancer: The ALEXANDRA/IMpassion030 Randomized Clinical Trial” published on JAMA Network.
Authors: Michail Ignatiadis, Andrew Bailey, Heather McArthur, Sarra El-abed, Evandro de Azambuja, Otto Metzger, Stephen Y. Chui, Max Dieterich, Thomas Perretti, Esther Shearer-Kang, Luciana Molinero, Günther G. Steger, Jacek Jassem, Soo Chin Lee, Michaela Higgins, Jose Zarba, Marcus Schmidt, Henry Gomez, Angel Guerrero Zotano, Luca Moscetti, Joanne Chiu, Elisabetta Munzone, Noa Efrat Ben-Baruch, Emilio Bajetta, Shinji Ohno, Seock-Ah Im, Gustavo Werutsky, Einav Nili Gal-Yam, Xavier Gonzalez Farre, Ling-Ming Tseng, William Jacot, Oleg Gluz, Zhimin Shao, Yaroslav Shparyk, Anastasia Zimina, Eric Winer, David A. Cameron, Giuseppe Viale, Shigehira Saji, Richard Gelber, Martine Piccart.
“The final analysis of the ALEXANDRA/IMpassion030 trial is now published in JAMA Network.
This is a negative study: Adjuvant atezolizumab does not improve invasive disease-free survival and increases treatment-related adverse events when added to standard adjuvant chemotherapy.
This is the largest immunotherapy trial in breast cancer and the only adjuvant immunotherapy trial in triple-negative breast cancer (TNBC).
The ALEXANDRA/IMpassion030 trial adds to growing evidence across breast cancer and other tumor types that neoadjuvant is more effective way to administer immunotherapy compared to adjuvant. These findings should be considered in multidisciplinary discussions at the time of TNBC diagnosis.
Many patients with stage II and III TNBC still undergo upfront surgery. Based on the findings from KEYNOTE-522 and ALEXANDRA/IMpassion030, these patients should be started with neoadjuvant chemoimmunotherapy. For patients with clinical stage I TNBC who undergo surgery and are upstaged postoperatively to pathological stage II or III, adjuvant immunotherapy should not be added to adjuvant chemotherapy.
Paolo Tarantino, Advanced research fellow at Dana-Farber Cancer Institute, shared this post on X, adding:
“Congrats Michail and team! Terrific effort. Unfortunate to see no benefit from adjuvant atezo, but we do learn a lot from negative results, and hope to see great biological insights from the study of the samples collected within the trial.”
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