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Tumor Discovery Immune and epigenetic therapies for TNBC

to enhance the assessment of TIL levels in clinical practice. their therapeutic potential in TNBC patients. In addition,
Standardized methodologies for TIL assessment, including mechanistic studies elucidating the interplay between
histopathological evaluation and immune profiling epigenetic alterations and immune checkpoint regulation
techniques, should be established to ensure consistency and can provide valuable insights into novel therapeutic targets
reliability across different health-care settings. Moreover, and strategies for TNBC treatment.
incorporating TIL assessment into TNBC clinical trials
can facilitate the evaluation of novel immunotherapeutic 7. Conclusion
approaches and the stratification of patient populations The immune system plays an essential part in cancer
based on TIL status. surveillance, influencing tumor progression and response

Furthermore, strategies targeting MDSCs hold promise to therapy. TILs are linked to a better prognosis in TNBC
for modulating the immunosuppressive TME in TNBC. patients, while immunosuppressive agents such as TAMs,
Preclinical and clinical studies investigating MDSC- Tregs, and MDSCs aid in immune evasion and tumor
targeting agents, such as inhibitors of MDSC recruitment growth. In TNBC, epigenetic changes – such as DNA
or function, should be prioritized. In addition, combination methylation and histone modifications – play a crucial
therapies integrating MDSC-targeting approaches role in controlling gene expression by silencing tumor
with standard treatments such as chemotherapy or suppressor genes, activating oncogenes, and affecting the
immunotherapy warrant exploration to enhance treatment immune recognition of cancer cells. ICIs and epigenetic
efficacy and overcome resistance mechanisms. Biomarker- medications together provide promise for improving
guided patient selection and monitoring are essential for TNBC outcomes, but there are still issues, including toxicity
optimizing MDSC-targeted therapies in TNBC. and drug interactions to be resolved. Novel therapeutic
Moreover, due to the complex role of Tregs in TNBC approaches, such as combining immunotherapy with
progression, strategies to modulate Treg function should epigenetic modulators to boost anti-tumor immunity
be pursued to restore anti-tumor immunity. Research and improve patient outcomes, may result from an
efforts should focus on identifying specific molecular understanding of the epigenetic control of immunological
targets and signaling pathways involved in Treg-mediated checkpoints and tumor-associated antigens in TNBC.
immunosuppression within the TME. Therapeutic
approaches targeting Treg accumulation or activity, such Acknowledgments
as Treg depletion or inhibition of Treg recruitment, should None.
be investigated in preclinical models and clinical trials.
Furthermore, combination therapies that include Treg- Funding
targeting agents with ICIs or other immunomodulators None.
may offer synergistic benefits in TNBC treatment.
In addition, TAMs play a critical role in shaping Conflict of interest
the immunosuppressive TME and promoting TNBC The authors declare that they have no competing interests.
progression. Therefore, targeting TAMs through various
strategies, including inhibition of TAM recruitment or Author contributions
repolarization of TAMs toward an anti-tumor phenotype,
holds therapeutic potential. Clinical trials evaluating TAM- Conceptualization: Vitalis Chukwuemeka Okwor, Chika
targeted therapies, such as CCL2–CCR2 axis inhibitors or Juliet Okwor, Stephen Abiodun Musayayi
bisphosphonate-based macrophage apoptosis inducers, Writing – original draft: Tolulope Judah Gbayisomore,
should be expanded to assess their efficacy and safety in Innocent Joseph, Isaac Olamide Babalola, Lucky
TNBC patients. In addition, biomarker-driven approaches Aighowmanfe Ayeni, Feranmi Emmanuel Obe
for patient selection and monitoring of treatment response Writing – review & editing: Vitalis Chukwuemeka Okwor,
are essential for the successful implementation of TAM- Chika Juliet Okwor, Abdul-Hanan Saani Inusah, Rufus
targeted therapies. Oluwagbemileke Ajayi, Tolulope Judah Gbayisomore
Finally, strategies to harness epigenetic mechanisms, Ethics approval and consent to participate
such as HDACis and DNMTis, should be explored to
enhance immune recognition and restore anti-tumor Not applicable.
immunity. Clinical trials evaluating the efficacy of Consent for publication
epigenetic-modifying agents alone or in combination
with immunotherapies should be conducted to assess Not applicable.

Volume 3 Issue 3 (2024) 12 doi: 10.36922/td.3383