Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jan;26(1):21-33.
doi: 10.1007/s11912-023-01487-1. Epub 2024 Jan 2.

Immunotherapy for Early-Stage Triple Negative Breast Cancer: Is Earlier Better?

Fei Song  1 , Paolo Tarantino  2   3   4 , Ana Garrido-Castro  2   3 , Filipa Lynce  2   3 , Sara M Tolaney  2   3 , Ilana Schlam  5   6
Affiliations
Review

Immunotherapy for Early-Stage Triple Negative Breast Cancer: Is Earlier Better?

Fei Song et al. Curr Oncol Rep. 2024 Jan.

Abstract

Purpose of review: In this narrative review, we discuss the optimal timing of immune checkpoint inhibitors (ICI) in early triple negative breast cancer (TNBC), the landscape of predictive biomarkers for the use of immunotherapy, and the mounting literature suggesting a benefit for an early use of ICI.

Recent findings: TNBC is associated with a poor prognosis relative to other breast cancer subtypes, and until recently, the treatment of TNBC was limited to cytotoxic chemotherapy. In 2021, the immune-checkpoint inhibitor, pembrolizumab, was approved in combination with neoadjuvant chemotherapy for patients with high-risk early stage TNBC. This approval changed the treatment paradigm of early TNBC concomitantly raised several challenges in clinical practice, pertaining to patient selection, toxicity management, and post-neoadjuvant treatment, among others. The introduction of neoadjuvant chemoimmunotherapy has transformed the treatment landscape for early TNBC. However, several challenges, including patient selection, toxicity management, and the identification of predictive biomarkers, need to be addressed. Future research should focus on refining the timing and duration of immunotherapy, optimizing the chemotherapy partner, and exploring novel predictive biomarkers of response or toxicity.

Keywords: Adjuvant therapy; Early breast cancer; Immunotherapy; Neoadjuvant chemotherapy; Triple negative breast cancer.

PubMed Disclaimer

References

    1. SEER Program (National Cancer Institute (U.S.) (2022) Recent trends in SEER age-adjusted incidence rates, 2010-2019.
    1. Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, Jemal A, Siegel RL. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72:524–41. - PubMed
    1. Schmid P, Cortes J, Pusztai L, et al. Pembrolizumab for early triple-negative breast cancer. N Engl J Med. 2020;382:810–21. - PubMed
    1. Asselain B, Barlow W, Bartlett J, et al. Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol. 2018;19:27.
    1. Cortazar P, Zhang L, Untch M, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. The Lancet. 2014;384:164–72.

Substances

LinkOut - more resources