Immune checkpoint inhibitor therapy: a major breakthrough in treating triple-negative breast cancer

Triple-negative breast cancer (TNBC) is an aggressive and challenging subtype of breast cancer characterized by poor prognosis and limited treatment options. Conventional therapies, primarily based on chemotherapy, often prove ineffective and are associated with significant side effects. Against this backdrop, the emergence of immune checkpoint inhibitors (ICI), such as PD-1/PD-L1 inhibitors, has opened new avenues for treatment. These therapies stimulate the immune system to recognize and destroy cancer cells and are generating growing interest. However, their precise role in the management of TNBC remains to be fully elucidated. This study evaluates the efficacy and safety of ICIs in treating unresectable, locally advanced, or metastatic TNBC.

ICIs: A revolution in TNBC treatment?

To explore this hypothesis, 11 randomized clinical trials involving a total of 4,314 patients with unresectable, locally advanced, or metastatic TNBC were selected. The efficacy of the treatment was assessed by analyzing the following outcomes: overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and treatment-related adverse events (TRAEs). Subgroup analyses were also conducted for PD-L1-positive patients to examine differences in response.

The findings demonstrate that PD-L1 inhibitors significantly improve OS in both the intention-to-treat and PD-L1-positive populations. Additionally, PFS also increased in these groups.

While immunotherapies were associated with an increase in immune-mediated adverse events (such as hypothyroidism, skin rashes, and pneumonitis), the incidence of severe events was not higher than with chemotherapy alone.

Finally, combining ICIs with chemotherapy showed superior clinical benefits compared to monotherapy, further reinforcing their relevance in managing TNBC.

A new hope in the fight against tnbc

This study confirms the potential of PD-1/PD-L1 inhibitors to transform the treatment landscape for advanced TNBC, particularly in PD-L1-positive patients. While these findings suggest that immunotherapy could become a cornerstone strategy for managing TNBC, challenges remain. These include optimizing its use, managing adverse effects, and identifying predictive biomarkers.