Breast Cancer: Dual Immunotherapy Achieves 50% Response in TNBC Without Chemotherapy

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Breast Cancer: Dual Immunotherapy Achieves 50% Response in TNBC Without Chemotherapy

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Breast Cancer: Dual Immunotherapy Achieves 50% Response in TNBC Without Chemotherapy.

Breakthrough in Triple-Negative Breast Cancer Treatment: Nearly 50% of Patients Achieve Complete Tumor Disappearance Without Chemotherapy.

Triple-negative breast cancer (TNBC) is known as the “most aggressive” subtype of breast cancer due to its high invasiveness, likelihood of recurrence, and potential for metastasis. Characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2), traditional treatments such as hormone therapy and targeted therapies are ineffective. Current treatment approaches primarily rely on surgery, supplemented by radiotherapy and chemotherapy. While previous studies have shown that adding immunotherapy to chemotherapy improves patients’ pathological complete response (pCR) rates and prognosis, the associated toxicities raise the need for less intensive treatment strategies.

Tumor-infiltrating lymphocytes (TILs) play a crucial role in the anti-tumor immune response by surrounding and attacking tumor cells, reducing the likelihood of metastasis. Patients with TNBC who have high TIL levels generally have a better prognosis, suggesting that treatments without chemotherapy could be a viable option for this group. However, it remains unclear how well these patients respond to immunotherapy alone in terms of achieving pCR.

At the 2024 European Society for Medical Oncology (ESMO) Congress, held in Barcelona, Spain, Professor Iris Nederlof from the Netherlands Cancer Institute presented the results of a groundbreaking exploratory clinical trial.

The study focused on patients with TNBC and high levels of TILs who were treated with short-course neoadjuvant immunotherapy (without chemotherapy).

Two dual-immunotherapy regimens were tested: one combining anti-PD-1 antibody nivolumab with anti-CTLA-4 antibody ipilimumab, and the other combining nivolumab with anti-LAG3 antibody relatlimab.

The pCR rates achieved were 33% and 47%, respectively. Further studies are needed to fully assess the efficacy and toxicity of immunotherapy in chemotherapy-free treatments for immunogenic TNBC.

The ESMO Congress is one of the most prestigious oncology conferences, presenting cutting-edge advancements in basic, translational, and clinical cancer research. The current conference highlights included breakthroughs across 18 topics, including non-small cell lung cancer, gastrointestinal tumors, breast cancer, and urological cancers, covering 83 studies in total.

The clinical trial enrolled 30 patients with stage I-II, lymph node-negative TNBC, and TIL levels of at least 50%. Patients were randomly assigned to two dual-immunotherapy groups: one group received nivolumab plus ipilimumab for 6 weeks (15 patients), and the other group received nivolumab plus relatlimab for 8 weeks (15 patients). The results were as follows:

Nivolumab + Ipilimumab Group: 33% (5/15) achieved pCR, and 53% (8/15) reached major pathological response (MPR, defined as less than 10% residual viable tumor).
Nivolumab + Relatlimab Group: 47% (7/15) achieved pCR, and 73% (11/15) reached MPR.
Regarding safety, eight patients (26.7%) experienced grade 3-4 adverse events, with six of these cases occurring in the nivolumab + ipilimumab group. The most common side effects included hypothyroidism, renal dysfunction, and diabetes.

This study marks a significant step forward in TNBC treatment, demonstrating that nearly half of the patients could potentially avoid chemotherapy while achieving complete tumor disappearance through immunotherapy alone. Further research is needed to confirm these findings and optimize treatment protocols.

Breast Cancer: Dual Immunotherapy Achieves 50% Response in TNBC Without Chemotherapy.

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(source:internet, reference only)

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