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Updated: Dec 6, 2025
Studying Triple Negative Breast Cancer Using Orthotopic Breast Cancer Model
Published on: March 20, 2020
Positive progress: current and evolving role of immune checkpoint inhibitors in metastatic triple-negative breast
Christine E Simmons1, Christine Brezden-Masley2, Joy McCarthy3
1Division of Medical Oncology, BC Cancer Agency-Vancouver, 600 West 10th Avenue, Vancouver, British Columbia, V5Z 4E6, Canada.
Background:
Triple-negative breast cancer (TNBC) represents an aggressive breast cancer subtype with historically poor overall outcomes, due primarily to a lack of effective targeted agents. Chemotherapy has been the primary treatment approach, although immune checkpoint inhibitors (ICIs) are currently being investigated to improve patient outcomes. This review examines the clinical implications of current evidence on the use of ICIs for the treatment of metastatic TNBC.
Methods:
Our systematic search identified two phase III and five phase I/II trials reporting on the efficacy of ICIs used as monotherapy or combined with chemotherapy for the treatment of metastatic TNBC.
Results:
The phase III IMpassion 130 trial showed a significant improvement in median progression-free survival in the intent-to-treat (net 1.7 months, p = 0.002) and PD-L1-positive populations (net 2.5 months, p < 0.001) for the addition of first-line atezolizumab versus placebo to nab-paclitaxel in metastatic TNBC. Although median overall survival was not significantly improved in patients receiving atezolizumab overall [net 2.3 months, hazard ratio (HR) 0.86, 95% confidence interval (CI) 0.72-1.02, p = 0.078], numerical improvements in the PD-L1-positive population were compelling (net 7.0 months, HR 0.71; 95% CI 0.54-0.93). Toxicity profiles were as expected, and no new safety signals were observed. Pembrolizumab monotherapy did not significantly improve overall survival in similar patients that had received prior treatment in KEYNOTE-119.
Conclusions:
Atezolizumab plus nab-paclitaxel represents a potential new first-line standard of care for patients with metastatic PD-L1-positive TNBC. Other ICIs used as monotherapy, or combined with chemotherapy for advanced TNBC, as well as their use for earlier stage disease, are areas of ongoing investigation.
Insights
Immune checkpoint inhibitors (ICIs) show promise for metastatic triple-negative breast cancer (TNBC). Atezolizumab plus nab-paclitaxel may become a new standard for PD-L1-positive TNBC patients.
Area of Science:
- Oncology
- Immunotherapy
- Breast Cancer Research
Background:
- Triple-negative breast cancer (TNBC) is an aggressive subtype with limited targeted treatment options.
- Chemotherapy is standard, but immune checkpoint inhibitors (ICIs) are under investigation.
- This review focuses on the clinical evidence for ICIs in metastatic TNBC.
Purpose of the Study:
- To review current evidence on the efficacy of immune checkpoint inhibitors (ICIs) for metastatic triple-negative breast cancer (TNBC).
- To evaluate the clinical implications of using ICIs as monotherapy or in combination with chemotherapy for TNBC treatment.
Main Methods:
- Systematic search of clinical trials.
- Included two Phase III and five Phase I/II trials.
- Focused on efficacy of ICIs in metastatic TNBC.
Main Results:
- The IMpassion 130 trial demonstrated improved progression-free survival with atezolizumab plus nab-paclitaxel in metastatic TNBC, particularly in PD-L1-positive patients.
- Overall survival showed numerical improvements in PD-L1-positive patients, though not statistically significant overall.
- Pembrolizumab monotherapy did not significantly improve overall survival in previously treated patients (KEYNOTE-119).
Conclusions:
- Atezolizumab plus nab-paclitaxel is a potential first-line standard of care for metastatic PD-L1-positive TNBC.
- Further research is ongoing for other ICIs in TNBC, including earlier stages of the disease.
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