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Neoadjuvant immunotherapy in breast cancer: Progress and challenges.
Manon de Graaf1, Alex De Caluwé2, Laurence Buisseret3
1Department of Tumor Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Trends in Cancer
|July 14, 2026
Summary
Neoadjuvant immunotherapy shows promise for breast cancer (BC), but not all patients benefit. Biomarkers are needed to personalize treatment, balancing efficacy and toxicity for better outcomes in BC immunotherapy.
Area of Science:
- Oncology
- Immunotherapy
- Breast Cancer Research
Background:
- Breast cancer (BC) was historically viewed as an 'immunologically cold' tumor.
- Anti-programmed cell death protein 1 (PD-1) therapies have emerged as a significant advancement, particularly in triple-negative breast cancer.
- Promising results from neoadjuvant Phase III trials are also seen in high-grade estrogen receptor-positive breast cancer.
Purpose of the Study:
- To review the current status of neoadjuvant immunotherapy in breast cancer.
- To identify challenges in current neoadjuvant immunotherapy approaches for breast cancer.
- To highlight the need for biomarkers to guide personalized treatment strategies.
Main Methods:
- Literature review of neoadjuvant immunotherapy in breast cancer.
- Analysis of clinical trial data for anti-PD-1 therapies in breast cancer.
- Discussion of biomarker development for immunotherapy response prediction.
Main Results:
- Anti-PD-1 therapy has transformed treatment for triple-negative breast cancer.
- Neoadjuvant immunotherapy shows potential in high-grade estrogen receptor-positive breast cancer.
- A significant subset of patients do not respond to current immunotherapy, necessitating combination strategies.
Conclusions:
- Neoadjuvant immunotherapy offers new hope for breast cancer patients.
- There is a critical need for prognostic and predictive biomarkers to optimize treatment selection.
- Balancing treatment efficacy with toxicity is essential for improving patient outcomes and avoiding overtreatment.
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