What is the appropriate approach to manage a patient with triple-negative, locally advanced breast cancer (LN+) who progresses on neoadjuvant chemo-immunotherapy (KEYNOTE-522 regimen)?  

Given the aggressiveness of the KEYNOTE-522 regimen, second-line chemo seems unlikely to be effective. Assuming the patient is currently not resectable, recommend breast RT concurrently with a well-tolerated radiosensitizer, e.g., capecitabine, dose, and fractionation depending on the presence or ab...

I have seen this a few times. We often consider second-line treatment. If, after that, they are resectable, we go to surgery. If they aren't resectable or borderline, we do consider neoadjuvant chemoradiation with capecitabine.

Unfortunate situation.  Options would be second-line chemo and then surgery or if operable now to do surgery followed by adjuvant chemo and RT.