Promising Response to Neoadjuvant Chemotherapy Plus Immunotherapy in Metaplastic Breast Carcinoma.

PURPOSE

Metaplastic breast carcinoma (MpBC) is a rare and aggressive subtype of breast cancer that often shows poor response to conventional neoadjuvant chemotherapy (NAC). This study aimed to evaluate the efficacy of combining NAC with immune checkpoint inhibitors (ICIs) in MpBC patients.

METHODS

We conducted a retrospective analysis of MpBC patients treated with NAC, with or without the addition of immunotherapy, at Sun Yat-sen university Cancer center between 2017 and 2024. We assessed clinical and pathological response to NAC in MpBC patients.

RESULTS

40 MpBC patients treated with NAC were identified, 33 patients treated with NAC alone, 7 patients treated with NAC and immunotherapy, 4 (10%) patients achieved pCR. Among the 33 patients treated with NAC alone, only 2 (6%) achieved pCR. In contrast, 7 patients received additional immunotherapy, and 3 started immunotherapy at the initiation of NAC, with 2 of these (67%) achieving pCR. Patients who received immunotherapy after disease progression on NAC showed varying degrees of tumor response, from stable disease (SD) to partial response (PR).

CONCLUSION

We observed a promising response on addition of immunotherapy to NAC among patients with MpBC, suggesting that immunotherapy may have great potential in the treatment of metaplastic breast carcinoma.