Pembrolizumab and atezolizumab in triple-negative breast cancer

Area of Science:

• Oncology
• Immunology

Background:

• Triple-negative breast cancer (TNBC) lacks estrogen receptor (ER), progesterone receptor (PgR), and HER2 expression, leading to poor prognosis and limited treatment options.
• TNBC exhibits higher immunogenicity, tumor-infiltrating lymphocytes (TILs), and PD-L1 expression, suggesting potential benefit from immune checkpoint blockade therapy.

Purpose of the Study:

• To review the development and recent advances of atezolizumab and pembrolizumab in treating early-stage and advanced/metastatic TNBC.
• To highlight the efficacy of immune checkpoint inhibitors (ICIs) in TNBC, particularly in PD-L1 positive subgroups and first-line settings.

Main Methods:

• Literature review of clinical studies and recent advances in immunotherapy for TNBC.
• Analysis of treatment outcomes for atezolizumab and pembrolizumab in different TNBC stages.

Main Results:

• Atezolizumab in combination with nab-paclitaxel is approved for unresectable locally advanced or metastatic TNBC with PD-L1 expression.
• Pembrolizumab shows promising results in early-stage TNBC, potentially leading to neoadjuvant/adjuvant setting approval.
• First-line ICI treatment appears more effective than later-line treatments for advanced/metastatic TNBC.

Conclusions:

• Immune checkpoint inhibitors, particularly atezolizumab and pembrolizumab, represent a significant advancement in TNBC treatment.
• PD-L1 expression is a key biomarker for predicting response to ICIs in TNBC.
• Further research and clinical trials are ongoing to optimize ICI therapy for all stages of TNBC.