KEYNOTE-355 Chemo Partners — SCE Medical Oncology MCQ

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ModerateBreast CancerKEYNOTE-355 Chemo PartnersSCE Medical Oncology

A 55-year-old woman with metastatic TNBC has PD-L1 CPS ≥10. She is starting first-line pembrolizumab + chemotherapy (KEYNOTE-355). Which chemotherapy partners are approved with pembrolizumab in this setting?

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Correct answer: E — Nab-paclitaxel, paclitaxel or gemcitabine-carboplatin — all three were used in KEYNOTE-355

KEYNOTE-355 allowed three chemotherapy backbones with pembrolizumab for PD-L1 CPS ≥10 metastatic TNBC: nab-paclitaxel, paclitaxel or gemcitabine-carboplatin. All three showed PFS benefit when combined with pembrolizumab. The choice depends on patient factors: nab-paclitaxel avoids steroid premedication; gemcitabine-carboplatin offers a platinum component (relevant for BRCA carriers); paclitaxel is widely available. Note: atezolizumab + nab-paclitaxel (IMpassion130) is no longer available after atezolizumab withdrawal from this indication.

Reference: NICE TA801 Pembrolizumab TNBC; KEYNOTE-355; ESMO 2024 MBC