Rethinking Adjuvant Immune Therapy for Triple Negative Breast Cancer
Immunotherapy stands as one of the most transformative breakthroughs in modern cancer treatment. These innovative therapies target signaling pathways used by cancer cells to induce T-cell exhaustion at immune checkpoints, allowing the cancer to evade immune detection. In the last 10 years, immune checkpoint inhibitors have achieved long-lasting responses and, in some cases, even cures for cancers that once had poor prognoses. However, the journey to proving the efficacy of immunotherapy in breast cancer has been anything but straightforward. It took 8 years after the initial approval of an immune checkpoint inhibitor for melanoma before breast cancer saw its first approval in 2019, when atezolizumab received an indication for metastatic triple-negative breast cancer (TNBC) based on the IMpassion130 trial. Shortly thereafter, the US Food and Drug Administration granted approval to pembrolizumab for metastatic TNBC, fueling optimism that patients with this aggressive form of cancer were on the cusp of reaping vast benefits from immune-based therapies. Yet excitement gave way to uncertainty following the negative results of IMpassion131, leading to the voluntary withdrawal of atezolizumab’s indication for TNBC. Although pembrolizumab remained in play, confidence in immune therapy for breast cancer had been shaken.
Immunotherapy stands as one of the most transformative breakthroughs in modern cancer treatment. These innovative therapies target signaling pathways used by cancer cells to induce T-cell exhaustion at immune checkpoints, allowing the cancer to evade immune detection. In the last 10 years, immune checkpoint inhibitors have achieved long-lasting responses and, in some cases, even cures for cancers that once had poor prognoses. However, the journey to proving the efficacy of immunotherapy in breast cancer has been anything but straightforward. It took 8 years after the initial approval of an immune checkpoint inhibitor for melanoma before breast cancer saw its first approval in 2019, when atezolizumab received an indication for metastatic triple-negative breast cancer (TNBC) based on the IMpassion130 trial. Shortly thereafter, the US Food and Drug Administration granted approval to pembrolizumab for metastatic TNBC, fueling optimism that patients with this aggressive form of cancer were on the cusp of reaping vast benefits from immune-based therapies. Yet excitement gave way to uncertainty following the negative results of IMpassion131, leading to the voluntary withdrawal of atezolizumab’s indication for TNBC. Although pembrolizumab remained in play, confidence in immune therapy for breast cancer had been shaken.
