Combination immunotherapy strategies for triple-negative breast cancer: current progress and barriers within the

Jacopo Uliano1,2, Eleonora Nicolò1,2, Carla Corvaja1,3

  • 1Division of New Drugs and Early Drug Development, European Institute of Oncology IRCCS, Milan, Italy.

Abstract

Insights

Triple-negative breast cancer (TNBC) treatment is evolving. Combining immune checkpoint inhibitors (ICIs) with other therapies shows promise, but overcoming resistance remains crucial for improving patient outcomes.

Area of Science:

  • Oncology
  • Immunotherapy
  • Breast Cancer Research

Background:

  • Triple-negative breast cancer (TNBC) presents a significant clinical challenge due to its aggressive nature and limited treatment options.
  • While anti-PD(L)1 immunotherapy shows potential in TNBC, monotherapy efficacy is often suboptimal, necessitating combination strategies.
  • Resistance to immune checkpoint inhibitors (ICIs) is a major obstacle, limiting their long-term benefit in TNBC patients.

Approach:

  • This review synthesizes the biological basis, current clinical data, and ongoing trials for combining immunotherapy with various agents in TNBC.
  • Investigates combinations of immunotherapy with novel immunotherapeutics, chemotherapy, targeted agents, and antibody-drug conjugates.
  • Focuses on strategies to overcome primary and secondary resistance to ICIs in the context of TNBC treatment.

Key Points:

  • Combination therapies, including ICIs plus chemotherapy, are increasingly integrated into TNBC treatment paradigms.
  • Exploiting synergistic effects between different therapeutic modalities is a key strategy to enhance ICI efficacy.
  • Identifying mechanisms of ICI resistance and developing predictive biomarkers are critical for patient selection and treatment optimization.

Conclusions:

  • The TNBC treatment landscape is dynamic, with ICIs now established, but significant unmet needs persist.
  • Novel combination strategies are essential to overcome resistance and extend the benefits of immunotherapy.
  • Future research should prioritize understanding ICI resistance and discovering robust biomarkers for personalized TNBC therapy.

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