ASO Author Reflections: Real-World Results of the KEYNOTE-522 Regimen to Guide Surgical Decision Making

PASTTriple-negative breast cancer (TNBC), which is notorious for its aggressive tumor biology and overall poorer prognosis, accounts for approximately 15% of all breast cancer diagnoses. 1-3The KEYNOTE-522 trial introduced immunotherapy into the neoadjuvant setting for patients with stage II/III TNBC, resulting in improved pathologic complete response (PCR) rates and event-free and overall survival. 4Surgical candidacy for breast-conservation therapy (BCT) can increase following neoadjuvant systemic therapy (NAT) but is often time contingent upon the degree of clinical response.In our study, we sought to evaluate whether patients undergoing NAT using the KEYNOTE-522 regimen in a real-world setting had improved pCR that correlated with an increased rate of breast conservation compared with patients who underwent NAT using the prior standard-ofcare regimen (control group). 5Additionally, we set out to evaluate BCT eligibility, effect on axillary surgery, identification of clinical characteristics to help predict pathologic response to NAT, identification of factors that influence surgery type, mean tumor reduction, and immune-related adverse events (irAEs).