Abstract
Objective To evaluate the efficacy and safety of programmed cell death receptor-1 (PD-1)/programmed cell death-ligand protein-1 (PD-L1) inhibitors in triple-negative breast cancer (TNBC) to provide a treatment basis for TNBC. Methods Published case-control studies on PD-1/PD-L1 inhibitors in the treatment of TNBC were retrieved from PubMed, Embase, and Cochrane Library databases, and collected data were processed by RevMan 5.4. Results A total of 7 studies with 4340 study subjects were obtained, including 2092 PD-L1-negative cases, 1375 PD-L1-positive cases, and 847 PD-L1 unidentified cases. The use of PD-1/PD-L1 inhibitors showed no significant impact on patients' progression-free survival (PFS) and overall survival (OS). The use of PD-1/PD-L1 inhibitors in the PD-L1-positive subgroup significantly improved patients' PFS and OS. Treatment with PD-1/PD-L1 inhibitors presented no significant effect on the incidence of adverse events (AEs) but increased the risk of AE grade ≥3 and severe AEs (SAEs). Conclusion PD-1/PD-L1 inhibitors are effective in the treatment of TNBC, which is strongly correlated with the expression of PD-L1; patient selection and clinical application require further investigation and verification.
Highlights
Breast cancer is the uncontrolled proliferation of breast epithelial cells induced by multiple oncogenic factors [1]
Triplenegative breast cancer (TNBC) is a breast cancer with the inexpression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2), which accounts for 12% of all breast cancer cases and is characterized by a young age of onset, high invasiveness, and easy recurrence and metastasis [4]. e 5-year survival of early-stage breast cancer exceeds 90%, that of patients with early-stage TNBC decreases to 77%, and that of patients with advanced TNBC remains only 14% [5]. e current treatments for TNBC are severely circumscribed owing to the insufficiency of effective therapeutic targets. e main treatment for advanced TNBC relies on chemotherapy with traditional anthracyclines, paclitaxel, and platinum [6] to prolong patients’ survival, but its efficiency still leaves much to be desired
Chemotherapy remains the basic treatment for TNBC
Summary
Breast cancer is the uncontrolled proliferation of breast epithelial cells induced by multiple oncogenic factors [1]. Its early manifestations include breast lumps, nipple overflow, and enlarged axillary lymph nodes, and distant metastasis of the disease in the advanced stage may develop multiorgan lesions, which is life-threatening [2]. E molecular types of breast cancer include Ki-67, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2), which provide diagnostic and prognostic evidence and guidance for treatment [3]. E main treatment for advanced TNBC relies on chemotherapy with traditional anthracyclines, paclitaxel, and platinum [6] to prolong patients’ survival, but its efficiency still leaves much to be desired. The marketed PD-1 inhibitors including nivolumab, pembrolizumab, and tislelizumab are mainly used for the treatment of melanoma and non-small-cell lung cancer, and their efficacy against renal cell carcinoma, bladder cancer, and Hodgkin’s lymphoma is still under large-scale clinical trials [10, 11]. Atezolizumab, durvalumab, and avelumab are PD-L1 inhibitors that have been clinically approved for the treatment of urothelial
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