Immunotherapy and breast cancer: an overview

Area of Science:

• Oncology
• Immunotherapy
• Breast Cancer Research

Background:

• Triple-negative breast cancer (TNBC) remains a challenging subtype with limited treatment options.
• Immune checkpoint inhibitors (ICI) have emerged as a promising therapeutic strategy.
• The role of ICI in both advanced and early-stage TNBC is under active investigation.

Purpose of the Study:

• To review the recent findings on the efficacy and safety of immune checkpoint inhibitors in triple-negative breast cancer.
• To evaluate the impact of ICI in combination with chemotherapy in different treatment settings.
• To discuss the implications of these findings for clinical practice and future research.

Main Methods:

• Review of clinical trial data, including KEYNOTE-522, focusing on progression-free survival and overall survival.
• Analysis of pathological complete response (pCR) rates in early-stage TNBC patients receiving neoadjuvant chemotherapy (NAC) with ICI.
• Assessment of safety profiles and management of ICI-related toxicities.

Main Results:

• ICI monotherapy did not outperform chemotherapy in pretreated advanced TNBC.
• Combination of ICI with chemotherapy demonstrated improved progression-free survival in PD-L1-positive advanced TNBC, with pembrolizumab showing a significant overall survival benefit.
• Pembrolizumab plus NAC significantly increased pCR and disease-free survival in early-stage TNBC (Stage II-III), establishing a new treatment paradigm.

Conclusions:

• Immune checkpoint inhibitors are integral to TNBC management.
• Optimizing chemotherapy partners and identifying predictive biomarkers are key future directions.
• Further research is needed to explore ICI in other breast cancer subtypes and manage potential toxicities.