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Immunotherapy for early triple negative breast cancer: research agenda for the next decade.

ABSTRACT: For decades, the systemic treatment of localized triple negative breast cancer (TNBC) has exclusively relied on chemotherapy. Recent advancements, however, are rapidly reshaping the treatment algorithms for this disease. The addition of pembrolizumab to neoadjuvant chemotherapy has indeed shown to significantly improve event-free survival for stage II-III TNBC, leading to its establishment as new standard of care in this setting. This landmark advancement has however raised several important scientific questions. Indeed, we desperately need strategies to identify upfront patients deriving benefit from the addition of immunotherapy. Moreover, the best integration of pembrolizumab with further recent advancements (capecitabine, olaparib) is yet to be defined. Lastly, extensive efforts are needed to minimize the impact on patients of immune-related adverse events and financial toxicity. The next decade of clinical research will be key to overcome these challenges, and ultimately learn how to optimally integrate immunotherapy in the treatment landscape of TNBC.

SUBMITTER: Tarantino P

PROVIDER: S-EPMC8857212 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Immunotherapy for early triple negative breast cancer: research agenda for the next decade.

Tarantino Paolo P Corti Chiara C Schmid Peter P Cortes Javier J Mittendorf Elizabeth A EA Rugo Hope H Tolaney Sara M SM Bianchini Giampaolo G Andrè Fabrice F Curigliano Giuseppe G

NPJ breast cancer 20220218 1

For decades, the systemic treatment of localized triple negative breast cancer (TNBC) has exclusively relied on chemotherapy. Recent advancements, however, are rapidly reshaping the treatment algorithms for this disease. The addition of pembrolizumab to neoadjuvant chemotherapy has indeed shown to significantly improve event-free survival for stage II-III TNBC, leading to its establishment as new standard of care in this setting. This landmark advancement has however raised several important sci ...[more]

PMID: 35181659

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Project description:BackgroundHealth Impact Assessment (HIA) advances Health in All Policies by identifying impacts of proposed actions on health and equity and recommending changes to address these impacts. Since the Gothenburg Consensus Statement in 1999, HIA has been applied to policies, plans, programmes and projects in multiple sectors and settings across the world. Despite demonstrated effectiveness, its use across the world is inconsistent with few nations systematically using HIA. In a global context of increasing health inequities, pandemics, climate change, and economic crises, HIA can help integrate health and equity into decision making. There is a need for research to support the ongoing evolution and development of HIA. This paper presents a research agenda for the field of HIA.MethodsWe used a mixed method approach utilising insights of approximately 280 participants through an international online survey and participatory workshops. We compared priority areas of research identified through the survey, workshops, and literature review to inform the development of a research agenda. The team drew on their own positioning and experience as HIA practitioners and researchers to shape this agenda.ResultsWe identified four research priorities: (1) Institutionalisation - Sustaining and institutionalising HIA in varying contexts and levels. (2) Influence - Identifying mechanisms and strategies that can be employed to effectively influence stakeholders and decision making. (3) Equity and Participation - Analysing the role of equity, justice, power and participation in HIA, and (4) Methodology - Improving HIA Methods to understand the complex relationships between proposed actions, health and health equity outcomes and identifying what to do. We developed research questions for each theme.ConclusionsThe research agenda advocates for sustained research and practice to strengthen impact and address knowledge gaps in the field. Functioning as a roadmap for both researchers and funders, it aims to contribute to a healthier and more equitable world. Recognising the valuable role of HIA in addressing global health challenges, the agenda encourages researchers to investigate, develop, and advance the field of HIA.

Project description:IntroductionAs the burgeoning roles of women afford them the opportunities to perform in all combat and combat support assignments, the impact of all environmental, occupational, physical, and psychosocial factors inherent in military training and operations on their health must be considered. A robust foundation of knowledge is necessary to ascertain, prevent, and treat the potential impacts on women's health. However, a systematic review of the literature from 2000-2015 revealed widespread gaps in scientific knowledge of the musculoskeletal, psychological, occupational, and reproductive health of military women. The purpose of this study is to determine priorities for military women's health (MWH) research that will serve to fill these gaps in knowledge.MethodsAn advisory group of 11 senior military and women's health experts conducted a structured gap analysis of the results of a scoping review of literature from 2000 to 2015 and Military Health System utilization data to identify 15 topics for prioritization in MWH research. A modified e-Delphi study was conducted and consensus was achieved after two rounds. Participants (N = 32) included subject matter experts (SME) representing various professions enrolled, 23 completed both rounds. In round 1, topics were rated on forced Likert scales for relevance and feasibility to medical readiness and comments were elicited from the SMEs. Relevance and feasibility scores and themes from the comments guided the development of the round 2 survey, in which SMEs categorized the topics in terms of urgency and forced-choice ranked the priority of each topic. The quantitative data were analyzed using multilevel regression methods. Linear mixed models were fit separately on the numeric outcomes for feasibility, relevance, and urgency with research topic as the primary predictor. To analyze the rankings of research topic priority, crude and adjusted linear regression models were fit on the numeric outcome rank.ResultsThe adjusted top five topics for research priorities as indicated by ranking were: genitourinary health, sleep, physical assault, behavioral health, and menstrual cycle research. The advisory group reviewed the findings in the context of Department of Defense strategic priorities and provided guidance on the design and dissemination of the MWH research agenda.ConclusionsThe MWH research agenda is a validated research agenda of high-priority research topics that will promote enduring efforts to ensure evidence-based practices and health policies for military women through research.

Dataset Information

Immunotherapy for early triple negative breast cancer: research agenda for the next decade.

Publications

Immunotherapy for early triple negative breast cancer: research agenda for the next decade.

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