Dr. Voorwerk on Rationale for Atezolizumab/Carboplatin in Metastatic Lobular Breast Cancer

Leonie Voorwerk, a PhD student at the Netherlands Cancer Institute, discusses the rationale for examining the combination of atezolizumab (Tecentriq) plus carboplatin in patients with metastatic lobular breast cancer.

This combination was examined in the phase 2 GELATO trial (NCT03147040) as an immune induction treatment for patients with metastatic lobular breast cancer, according to Voorwerk. Invasive lobular breast cancer is the most common histological subtype; it acts as a different disease entity vs other breast cancers without the subtype in terms of metastases patterns and a higher level of estrogen receptor expression in most patients, Voorwerk explains.

Translational data have indicated that a subset of patients with invasive lobular carcinoma (ILC) are categorized as immune-related, with a high expression of immune-related genes, immune checkpoints, and a higher abundance of tumor-infiltrating lymphocytes. Moreover, in vitro research has indicated that immune-related ILCs may be more sensitive to platinum agents, Voorwerk says. Mouse models for metastatic ILC have also identified synergy between immune checkpoint blockades and platinum agents. 

These previous findings helped to build the rationale for the exploration of the combination in the GELATO trial, Voorwerk concludes.