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Tumor Discovery

REVIEW ARTICLE
Facts and challenges of immunotherapy in

triple-negative breast cancer

1
1
Xuehai Wang , Fengxu Wang , Weiyi Xia , Siyuan Deng , Hongxiang Zhang ,
1
2
1
and Xinyuan Zhao *
1
1 Department of Occupational Medicine and Environmental Toxicology, Nantong Key Laboratory of
Environmental Toxicology, School of Public Health, Nantong University, Nantong 226019, China
2 College of Environment and Resources, Southwest University of Science and Technology,
Mianyang, Sichuan, 621010, China
Abstract
Triple-negative breast cancer (TNBC) is an aggressive but common cancer subtype
in clinical practice. Immune activation has been observed in a subgroup of TNBC,
suggesting that immunotherapy may be a potential therapeutic option. With the
widespread use of monotherapy, specific immune checkpoint inhibitors (ICIs)
such as avelumab, pembrolizumab, and atezolizumab have made significant
contributions to improving outcomes in both early and advanced TNBC. In addition,
the expressions of immune regulators such as cytotoxic T-lymphocyte-associated
protein 4, programmed cell death 1 (PD-1), and programmed cell death-ligand 1
(PD-L1), which are influenced by tumor-infiltrating lymphocytes (TILs), are also
critical factors in determining the effect of immunotherapy in TNBC. This review
focuses on the updates on the biological underpinnings of TNBC and the associated
treatment advances. We present the current landscape of well-known immune
regulators and widely used ICIs for TNBC and highlight the future directions that
*Corresponding author: are significant for further improving the efficacy and effect of targeted therapeutic
Xinyuan Zhao
(zhaoxinyuan@ntu.edu.cn) strategies to immunotherapy in TNBC and more reliable prognostic predictions for
tailored therapy in the future.
Citation: Wang X, Wang F, Xia W,
et al., 2022, Facts and challenges
of immunotherapy in triple-negative
breast cancer. Tumor Discov, Keywords: Triple-negative breast cancer; Immunotherapy; Immune checkpoint inhibitors;
1(2): 196. Programmed cell death 1/Programmed cell death-ligand 1; Cytotoxic T-lymphocyte-
https://doi.org/10.36922/td.v1i2.196 associated protein 4
Received: September 15, 2022
Accepted: November 15, 2022
Published Online: December 7,
2022 1. Introduction
Copyright: © 2022 Author(s).
This is an Open Access article Fifteen to twenty percentages of all human breast cancers (BCs) are triple-negative breast
distributed under the terms of the cancer (TNBC). TNBC is characterized by the absence of expression of human epidermal
Creative Commons Attribution growth factor receptor 2 (HER2), estrogen receptor (ER), and progesterone receptor
License, permitting distribution,
and reproduction in any medium, (PR). TNBC frequently exhibits aggressive characteristics, including early recurrence
provided the original work is and metastasis . With regard to overall survival (OS), if a patient is found to have stage
[1]
properly cited. 1 TNBC, the 5-year survival rate of the patient is nearly 94.7% due to good immune
Publisher’s Note: AccScience condition and nutrition absorption. The 5-year survival rate of patients with stage 2
Publishing remains neutral with TNBC, where the cancer continues to spread but is still confined within the breast or has
regard to jurisdictional claims in
published maps and institutional only affected adjacent lymph nodes, is about 86.37%. In stage 3 TNBC, the cancer has
affiliations. expanded past the tumor’s local vicinity and may have even infiltrated adjacent muscles

Volume 1 Issue 2 (2022) 1 https://doi.org/10.36922/td.v1i2.196