Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
Goethe University Frankfurt, Germany.
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-13. doi: 10.1200/EDBK_351186.
Triple-negative breast cancer (TNBC) is the most aggressive histologic subtype of breast cancer for which, until recently, treatment options have been limited to chemotherapy. In recent years, an improved understanding of the importance of tumor-infiltrating lymphocytes and the tumor microenvironment in TNBC has led to investigation of immune checkpoint inhibitors for treatment. There is now evidence from several randomized controlled trials that supports the addition of immune checkpoint inhibitors to first-line treatment of advanced TNBC and to neoadjuvant chemotherapy for stage II-III TNBC. In parallel, the PARP inhibitors have emerged as a targeted therapy option for patients with HER2-negative breast cancer harboring mutations in , and . Here, we review the recent clinical trials that inform the integration of immune checkpoint inhibitors into treatments for TNBC and discuss ongoing challenges-including patient selection, management of resistance to post-checkpoint inhibitor therapy, and combining immunotherapy with targeted therapies, including PARP inhibitors.
三阴性乳腺癌（TNBC）是乳腺癌中最具侵袭性的组织学亚型，直到最近，其治疗选择一直局限于化疗。近年来，人们对肿瘤浸润淋巴细胞和 TNBC 肿瘤微环境的重要性的认识不断提高，促使人们研究免疫检查点抑制剂用于治疗。目前，几项随机对照试验的证据支持将免疫检查点抑制剂添加到晚期 TNBC 的一线治疗和 II-III 期 TNBC 的新辅助化疗中。与此同时，PARP 抑制剂已成为携带有 和 突变的 HER2 阴性乳腺癌患者的一种靶向治疗选择。在这里，我们回顾了最近的临床试验，这些试验为将免疫检查点抑制剂纳入 TNBC 的治疗提供了信息，并讨论了正在面临的挑战，包括患者选择、对检查点抑制剂治疗后耐药的管理，以及将免疫疗法与靶向疗法（包括 PARP 抑制剂）相结合。
