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Triple-negative breast cancers, which are more frequently diagnosed in younger women, are a subtype of breast tumor characterized by the absence of hormone receptors and HER2 overexpression. As a result, they do not respond to hormone therapy or HER2-targeted treatments. Their prognosis is generally less favorable than that of other breast cancer subtypes.

Immunotherapy, particularly immune checkpoint inhibitors, has transformed the treatment of several cancers. In stage II and III triple-negative breast cancer, the addition of immunotherapy to chemotherapy before surgery increases the likelihood of achieving a pathological complete response and improves event-free survival, thereby reducing the risk of disease recurrence. However, for patients with small stage I tumors, chemotherapy administered before or after surgery remains the standard of care when indicated.

"Today, some patients with localized stage I triple-negative breast cancer receive chemotherapy even though some of them may not actually need it. It is essential to explore strategies that preserve treatment efficacy while reducing short- and long-term side effects. The POP-DURVA study aims to assess whether very early administration of immunotherapy can induce a sufficient antitumor response and pave the way for treatment de-escalation in selected patients," explains Dr. Joana Ribeiro.

POP-DURVA is a prospective, multicenter, single-arm phase 2 study sponsored by Gustave Roussy. It evaluated a short course of durvalumab, an anti-PD-L1 immunotherapy, administered before standard treatment, which consisted either of surgery or preoperative chemotherapy, in patients with stage I triple-negative breast cancer and tumors measuring less than two centimeters.

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