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Positive progress: current and evolving role of immune checkpoint inhibitors in metastatic triple-negative breast cancer.

ABSTRACT: Background:Triple-negative breast cancer (TNBC) represents an aggressive breast cancer subtype with historically poor overall outcomes, due primarily to a lack of effective targeted agents. Chemotherapy has been the primary treatment approach, although immune checkpoint inhibitors (ICIs) are currently being investigated to improve patient outcomes. This review examines the clinical implications of current evidence on the use of ICIs for the treatment of metastatic TNBC. Methods:Our systematic search identified two phase?III and five phase?I/II trials reporting on the efficacy of ICIs used as monotherapy or combined with chemotherapy for the treatment of metastatic TNBC. Results:The phase?III IMpassion 130 trial showed a significant improvement in median progression-free survival in the intent-to-treat (net 1.7?months, p?=?0.002) and PD-L1-positive populations (net 2.5?months, p?

SUBMITTER: Simmons CE

PROVIDER: S-EPMC7517981 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Positive progress: current and evolving role of immune checkpoint inhibitors in metastatic triple-negative breast cancer.

Simmons Christine E CE Brezden-Masley Christine C McCarthy Joy J McLeod Deanna D Joy Anil Abraham AA

Therapeutic advances in medical oncology 20200320

<h4>Background</h4>Triple-negative breast cancer (TNBC) represents an aggressive breast cancer subtype with historically poor overall outcomes, due primarily to a lack of effective targeted agents. Chemotherapy has been the primary treatment approach, although immune checkpoint inhibitors (ICIs) are currently being investigated to improve patient outcomes. This review examines the clinical implications of current evidence on the use of ICIs for the treatment of metastatic TNBC.<h4>Methods</h4>Ou ...[more]

PMID: 33014143

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Project description:Immunotherapy has emerged as the fifth pillar of cancer treatment alongside surgery, radiotherapy, chemotherapy, and targeted therapy. Immune checkpoint inhibitors are the current superheroes of immunotherapy, unleashing a patient's own immune cells to kill tumors and revolutionizing cancer treatment in a variety of cancers. Although breast cancer was historically believed to be immunologically silent, treatment with immune checkpoint inhibitors has been shown to induce modest responses in metastatic breast cancer. Given the inherent heterogeneity of breast tumors, this raised the question whether certain breast tumors might benefit more from immune-based interventions and which cancer cell-intrinsic and/or microenvironmental factors define the likelihood of inducing a potent and durable anti-tumor immune response. In this review, we will focus on triple negative breast cancer as immunogenic breast cancer subtype, and specifically discuss the relevance of tumor mutational burden, the plethora and diversity of tumor infiltrating immune cells in addition to the immunoscore, the presence of immune checkpoint expression, and the microbiome in defining immune checkpoint blockade response. We will highlight the current immune checkpoint inhibitor treatment options, either as monotherapy or in combination with standard-of-care treatment modalities such as chemotherapy and targeted therapy. In addition, we will look into the potential of immunotherapy-based combination strategies using immune checkpoint inhibitors to enhance both innate and adaptive immune responses, or to establish a more immune favorable environment for cancer vaccines. Finally, the review will address the need for unambiguous predictive biomarkers as one of the main challenges of immune checkpoint blockade. To conclude, the potential of immune checkpoint blockade for triple negative breast cancer treatment could be enhanced by exploration of aforementioned factors and treatment strategies thereby providing promising future prospects.

Dataset Information

Positive progress: current and evolving role of immune checkpoint inhibitors in metastatic triple-negative breast cancer.

Publications

Positive progress: current and evolving role of immune checkpoint inhibitors in metastatic triple-negative breast cancer.

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