Department of Immunology, Transplantology and Internal Diseases, University Clinical Center of the Medical University in Warsaw, Warsaw, Poland.
Cancer Immunol Immunother. 2021 Mar;70(3):607-617. doi: 10.1007/s00262-020-02736-z. Epub 2020 Oct 5.
Triple-negative breast cancer (TNBC) is defined by a lack of expression of both estrogen (ER) and progesterone (PgR) receptors as well as human epidermal growth factor receptor 2 (HER2) and is associated with poor prognosis. Moreover, the systemic treatment options are limited. However, the TNBC is more likely than other breast cancer subtypes to benefit from immune checkpoint blockade therapy due to its higher immunogenicity, higher enrichment by tumour-infiltrating lymphocytes (TILs), and higher levels of programmed cell death ligand 1 (PD-L1) expression. Thus far, atezolizumab was approved in combination with nab-paclitaxel for patients with unresectable locally advanced or metastatic TNBC whose tumours express PD-L1. Currently, it seems that PD-L1-positive subgroup will potentially benefit the most from the immune checkpoint inhibitor (ICI) treatment. Moreover, it seems that better results are seen when an ICI is given as first-line treatment than when an ICI is given in later lines of treatment for advanced TNBC/metastatic TNBC. Recently, pembrolizumab has demonstrated promising results in early-stage TNBC what can lead in near future to its approval in (neo)adjuvant setting. This review summarizes the development and highlights recent advances of the atezolizumab and pembrolizumab in early and advanced/metastatic TNBC.
三阴性乳腺癌（TNBC）的定义为缺乏雌激素（ER）和孕激素（PgR）受体以及人表皮生长因子受体 2（HER2）的表达，并且与预后不良相关。此外，其系统治疗选择有限。然而，由于其更高的免疫原性、更高的肿瘤浸润淋巴细胞（TILs）富集度以及更高水平的程序性细胞死亡配体 1（PD-L1）表达，TNBC 比其他乳腺癌亚型更有可能受益于免疫检查点阻断治疗。迄今为止，阿替利珠单抗已与nab-紫杉醇联合用于局部晚期或转移性 TNBC 患者，这些患者的肿瘤表达 PD-L1。目前，似乎 PD-L1 阳性亚组将最有可能从免疫检查点抑制剂（ICI）治疗中获益。此外，当 ICI 作为一线治疗时，似乎比在晚期 TNBC/转移性 TNBC 的后续治疗中使用 ICI 时，结果更好。最近，派姆单抗在早期 TNBC 中显示出有希望的结果，这可能导致其在不久的将来在（新）辅助治疗环境中获得批准。本综述总结了阿替利珠单抗和派姆单抗在早期和晚期/转移性 TNBC 中的开发情况，并强调了最近的进展。
