Triple Negative Breast Cancer (TNBC)Triple negative breast cancer (TNBC) is characterised by a lack of clinically significant expression levels of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2). This type of cancer therefore tends to have a worse prognosis and fewer treatment options than other breast cancers. Nevertheless, immune checkpoint inhibitors have substantially impacted treatment outcomes for patients with TNBC and have led to a paradigm shift of testing triple-negative tumours for programmed death ligand 1 (PD-L1) when considering chemoimmunotherapy for metastatic disease. Consequently, most of the marketed and pipeline drugs for the treatment of TNBC target programmed cell death protein 1 (PD-1).
Roche’s Tecentriq (atezolizumab) is another immune checkpoint inhibitor that is an anti-PD-L1 mAb, boosting the immune system’s capacity to stop cancer growth. However, in June 2021, after several years on the market, Roche withdrew its application to extend the use of atezolizumab to the treatment of patients with early or locally advanced TNBC in Europe. This came after confirmatory trials did not indicate a clinical benefit to treatment, providing just one example of the difficulty of getting new drugs to the TNBC market.
Overall, it seems clear that there is a significant need for novel therapeutics to treat TNBC, but finding a drug with clinical benefits is proving difficult due to TNBC’s low response to therapeutics and highly invasive nature. As TNBC is responsible for roughly 15% of breast cancers, further research and clinical advancement in this area is crucial in order to expand survival rates from this aggressive cancer.
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