Medical Minute 3: Evolving Treatment Landscape for Early-Stage TNBC With and Without gBRCAm : Pre-test

1.

How many people with breast cancer do you provide care for in a typical month?

A. 1-4
B. 5-10
C. 11-15
D. 16-20
E. >20
F. Not applicable

2.

For those who practice in academic or community settings, please indicate your practice setting:

A. Academic
B. Community
C. Not applicable

3.

Ms Jackson is a 61-year-old elementary math teacher living in Detroit, Michigan, with newly diagnosed locally advanced stage III TNBC of the right breast. Because of a maternal family history of ovarian cancer, she had been proactive about biennial mammography screening. Germline genetic testing revealed a BRCA1 mutation. She received 8 cycles of neoadjuvant carboplatin/paclitaxel followed by doxorubicin/cyclophosphamide plus pembrolizumab but did not achieve a pathologic complete response (pCR). She plans to continue postoperative adjuvant pembrolizumab as part of the perioperative regimen initiated before surgery.

Based on her germline BRCA status, residual disease, FDA labeling, and current clinical guidelines, which additional adjuvant systemic therapy would be indicated?

A. Add adjuvant capecitabine therapy
B. Add 1 year of adjuvant olaparib
C. Continue adjuvant pembrolizumab monotherapy
D. Use ovarian function suppression after surgery and 1 year of datopotamab deruxtecan (Dato-DXd)

4.

Diane is a 59-year-old retired attorney with stage II TNBC. She has residual invasive disease after neoadjuvant carboplatin/paclitaxel followed by doxorubicin/cyclophosphamide plus pembrolizumab. Germline testing is negative for BRCA1/2 pathogenic variants. She was recently diagnosed with Crohn’s disease. You both wish to minimize the risk of gastrointestinal (GI) toxicity with intended therapy.

Based on shared decision-making, available evidence, guideline recommendations, and the goal of minimizing immune-mediated GI toxicity, which postsurgical approach is most appropriate?

A. Add adjuvant capecitabine therapy
B. Continue adjuvant pembrolizumab therapy
C. Add 1 year of adjuvant olaparib
D. Adjuvant radiotherapy alone

5.

Which TROP-2–directed antibody–drug conjugate (ADC) is being evaluated with durvalumab as neoadjuvant therapy in the phase III TROPION-Breast04 trial for patients with early-stage TNBC?

A. Dato-DXd only
B. Sacituzumab govitecan only
C. Dato-DXd and sacituzumab govitecan
D. Dato-DXd, sacituzumab govitecan, and sacituzumab tirumotecan

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Medical Minute 3: Evolving Treatment Landscape for Early-Stage TNBC With and Without gBRCAm

Kristen D. Whitaker, MD, MS

Pretest

Please answer the questions below.

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