Progress and challenges of immunotherapy in triple-negative breast cancer

Area of Science:

• Oncology
• Immunology
• Genetics

Background:

• Triple-negative breast cancer (TNBC) lacks ER, PR, and HER2 expression, leading to poorer outcomes and limited targeted therapies.
• Chemotherapy has been the mainstay for TNBC, but its efficacy is limited by recurrence and metastasis.
• The immunogenicity of TNBC has spurred interest in immune checkpoint inhibition (ICI) and other immunotherapies.

Purpose of the Study:

• To review current advancements in immunotherapy for TNBC.
• To explore novel immunotherapeutic strategies beyond ICI.
• To discuss predictive biomarkers and future challenges in TNBC immunotherapy.

Main Methods:

• Literature review of clinical studies on TNBC immunotherapy.
• Analysis of data on programmed death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors and cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) inhibitors.
• Evaluation of novel approaches including vaccines and CAR-T cells.

Main Results:

• ICI, including PD-1/PD-L1 and CTLA-4 inhibitors, is a key treatment strategy for TNBC.
• Emerging immunotherapies like peptide vaccines, CTA, new antigen vaccines, RNA vaccines, and CAR-T cells offer alternative treatment avenues.
• Biomarkers such as PD-L1 expression, tumor mutational burden (TMB), tumor-infiltrating lymphocytes (TILs), and MSI/MMR deficiency are crucial for predicting treatment response.

Conclusions:

• Immunotherapy, particularly ICI, represents a significant advancement in TNBC treatment.
• Combination strategies and novel immunotherapeutic approaches hold potential for improving patient survival.
• Addressing challenges in biomarker identification and treatment resistance is essential for future progress in TNBC immunotherapy.