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In the phase II GELATO trial patients with invasive lobular breast cancer, the second most common histological breast cancer subtype, were treated with atezolizumab and carboplatin showing the feasibility of trials specifically designed to address the needs of these population of patients. The results, recently published on Nature Cancer, also demonstrated a promising antitumor activity for the combination.
Invasive lobular breast cancer specific trials are lacking, despite the frequency of this tumors. Translational research revealed an immune-related invasive lobular breast cancer subset, and in mouse models a synergy between immune checkpoint blockade and platinum was observed. Accordingly, GELATO trail treated 23 patients with invasive lobular breast cancer with weekly carboplatin as immune induction for 12 weeks and atezolizumab for a PD-L1 blockade triweekly, from the third week until progression. Four patients had a partial response (17%), and 2 had stable disease, resulting in a clinical benefit rate of 26%; from these six patients, four had triple-negative invasive lobular breast cancer. While carboplatin alone neither led to significant changes in immune cell composition, the addition of anti-PD-L1 caused an increase in CD8+ T cell infiltration and higher expression of immune-related gene signatures. «The GELATO trial is the earliest reported clinical trial conducted specifically in patients with invasive lobular breast cancer based on a hypothesis founded on preclinical and translational data», authors write. «We report on a clinical trial specific for metastatic invasive lobular breast cancer representing a difficult-to-treat breast cancer subtype, and we demonstrate that the combination of carboplatin and anti-PD-L1 induces clinical and immunological responses in a subset of patients with invasive lobular breast cancer. Most of the responses were observed in patients with triple-negative invasive lobular breast cancer, highlighting that patients with triple negative breast cancer should be considered for immune checkpoint blockade regardless of histological subtype. Our work provides hypotheses and paves the way for highly needed invasive lobular breast cancer-specific clinical trials», authors conclude.
In the phase II GELATO trial patients with invasive lobular breast cancer, the second most common histological breast cancer subtype, were treated with atezolizumab and carboplatin showing the feasibility of trials specifically designed to address the needs of these population of patients. The results, recently published on Nature Cancer, also demonstrated a promising antitumor activity for the combination.
Invasive lobular breast cancer specific trials are lacking, despite the frequency of this tumors. Translational research revealed an immune-related invasive lobular breast cancer subset, and in mouse models a synergy between immune checkpoint blockade and platinum was observed. Accordingly, GELATO trail treated 23 patients with invasive lobular breast cancer with weekly carboplatin as immune induction for 12 weeks and atezolizumab for a PD-L1 blockade triweekly, from the third week until progression. Four patients had a partial response (17%), and 2 had stable disease, resulting in a clinical benefit rate of 26%; from these six patients, four had triple-negative invasive lobular breast cancer. While carboplatin alone neither led to significant changes in immune cell composition, the addition of anti-PD-L1 caused an increase in CD8+ T cell infiltration and higher expression of immune-related gene signatures. «The GELATO trial is the earliest reported clinical trial conducted specifically in patients with invasive lobular breast cancer based on a hypothesis founded on preclinical and translational data», authors write. «We report on a clinical trial specific for metastatic invasive lobular breast cancer representing a difficult-to-treat breast cancer subtype, and we demonstrate that the combination of carboplatin and anti-PD-L1 induces clinical and immunological responses in a subset of patients with invasive lobular breast cancer. Most of the responses were observed in patients with triple-negative invasive lobular breast cancer, highlighting that patients with triple negative breast cancer should be considered for immune checkpoint blockade regardless of histological subtype. Our work provides hypotheses and paves the way for highly needed invasive lobular breast cancer-specific clinical trials», authors conclude.
