Would you consider adding pembrolizumab to adjuvant chemotherapy in a patient with stage 3 TNBC who did not receive neoadjuvant treatment?  

It seems that we might be missing some key clinical information here. However, I assume that this was high risk enough - given the ki-67, potentially LN positive, and larger size tumor to make the treating physician concerned. As a first point, while the ctDNA reflects (based on accumulating data)...

Based on the current data available, I would not recommend administering pembrolizumab. There is definitely some detailed clinical data missing. I speculate that we are talking about no BRCA mutation and TNBC setting. At this point, there is no clinical trial data to support the use of adjuvant pemb...

It would be typical for high risk patients to have had neoadjuvant chemotherapy. The KEYNOTE-522 study used pembro as paclitaxel/carbo-pembro/AC neoadjuvantly, and continued pembro alone for 9 cycles in the adjuvant setting. So high risk TNBC patients should ideally get neoadjuvant pembro/chemo foll...

If she's BRCA positive, I'd favor olaparib per OlympiA trial over capecitabine per CREATE-X. The answer to the posed question, however, will probably wait until we have the results from SWOG S1418 (completed enrollment early this summer).