Combination of Adjuvant Chemotherapy and Pembrolizumab for Primary Triple-Negative Neuroendocrine Breast Carcinoma

Overview

This report presents a case of a 71-year-old woman with primary triple-negative neuroendocrine breast carcinoma (NEBC) treated with adjuvant chemotherapy and pembrolizumab. The patient achieved a disease-free status at 12 months post-treatment, suggesting potential benefits of this regimen in a rare subtype of breast cancer.

Background

Neuroendocrine breast cancer (NEBC) is a rare and aggressive form of breast cancer, accounting for less than 1% of all breast tumors. The lack of standardized treatment guidelines for NEBC complicates management, necessitating exploration of existing therapies such as pembrolizumab, which has shown promise in other forms of triple-negative breast cancer (TNBC). Understanding the efficacy of pembrolizumab in NEBC could inform future treatment protocols.

Data Highlights

No numerical data was provided in the article.

Key Findings

• A 71-year-old woman diagnosed with primary triple-negative NEBC underwent radical mastectomy and sentinel lymph node biopsy.
• The patient received adjuvant therapy with paclitaxel, cisplatin, and pembrolizumab, which was well tolerated.
• Histopathological analysis confirmed NEBC with PD-L1 positivity (CPS ≥10) and a germline BRCA1/2 mutation.
• At 12 months post-treatment, the patient remained disease-free with no evidence of recurrence.
• This case represents one of the first reports of combining pembrolizumab with chemotherapy in the adjuvant setting for primary triple-negative NEBC.

Clinical Implications

The successful treatment of this patient with pembrolizumab and chemotherapy may encourage further investigation into similar regimens for NEBC. Clinicians should consider the potential role of immunotherapy in managing rare breast cancer subtypes, particularly those with neuroendocrine features.

Conclusion

This case study highlights the potential of combining pembrolizumab with chemotherapy for treating primary triple-negative NEBC, warranting further research to establish effective treatment protocols for this rare cancer subtype.

Related Resources & Content

1. The ASCO Post, 2022 -- Identifying Women With Triple-Negative Breast Cancer Who May Benefit From Pembrolizumab Plus Chemotherapy
2. The ASCO Post, 2022 -- KEYNOTE-522: Sensitivity Analyses Confirm Value of Neoadjuvant Pembrolizumab in Triple-Negative Breast Cancer
3. The ASCO Post, 2024 -- Overall Survival Analysis Confirms Pembrolizumab Regimen as Standard of Care for Triple-Negative Breast Cancer
4. Neuroendocrine neoplasms of the breast: a review of literature | Virchows Archiv | Springer Nature Link
5. The ASCO Post — KEYNOTE-522: Neoadjuvant Pembrolizumab Improves Event-Free Survival in Triple-Negative Breast Cancer Related Articles
6. Neuroendocrine neoplasms of the breast: a review of literature | Virchows Archiv | Springer Nature Link
7. Event-free Survival with Pembrolizumab in Early Triple-Negative Breast Cancer
8. https://www.frontiersin.org/articles/10.3389/or.2024.12114/pdf