Nivolumab with Chemotherapy in Early ER+ Breast Cancer

1. What was the trial about?

   Doctors tested whether adding nivolumab (an immunotherapy drug) to chemotherapy before surgery could help patients with ER+/HER2−. This type of cancer usually doesn’t respond well to neoadjuvant (before surgery) chemo, but researchers wanted to see if nivolumab could make chemotherapy work better.

2. How did the trial work?

   Over 500 patients were split into two groups. One group got nivolumab + chemotherapy, while the other got a placebo + chemotherapy. Then, doctors checked how many patients had no cancer left in their breast and lymph nodes after treatment.

3. What were the results?

   -24.5% of patients in the nivolumab group had no remaining cancer, compared to 13.8% in the placebo group.

   -Patients with certain immune markers (PD-L1 positive) had even better responses (44.3% vs. 20.2%).

   -However, two people in the nivolumab group died due to serious side effects, while no deaths happened in the placebo group.

4. What does this mean for the future?

   This study suggests that immunotherapy could help more breast cancer patients than previously thought - especially those with certain immune system markers. However, serious side effects are a concern, so more research is needed to figure out which patients would benefit the most without high risks.