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Pembrolizumab and atezolizumab in triple-negative breast cancer

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Triple-negative breast cancer (TNBC) is defined by a lack of expression of both estrogen (ER) and progesterone (PgR) receptors as well as human epidermal growth factor receptor 2 (HER2) and is associated with poor prognosis. Moreover, the systemic treatment options are limited. However, the TNBC is more likely than other breast cancer subtypes to benefit from immune checkpoint blockade therapy due to its higher immunogenicity, higher enrichment by tumour-infiltrating lymphocytes (TILs), and higher levels of programmed cell death ligand 1 (PD-L1) expression. Thus far, atezolizumab was approved in combination with nab-paclitaxel for patients with unresectable locally advanced or metastatic TNBC whose tumours express PD-L1. Currently, it seems that PD-L1-positive subgroup will potentially benefit the most from the immune checkpoint inhibitor (ICI) treatment. Moreover, it seems that better results are seen when an ICI is given as first-line treatment than when an ICI is given in later lines of treatment for advanced TNBC/metastatic TNBC. Recently, pembrolizumab has demonstrated promising results in early-stage TNBC what can lead in near future to its approval in (neo)adjuvant setting. This review summarizes the development and highlights recent advances of the atezolizumab and pembrolizumab in early and advanced/metastatic TNBC.

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Adverse event


Protein kinase B


Anti-programmed death receptor 1


American Society of Clinical Oncology


Advanced triple-negative breast cancer


Breast cancer


Breast cancer gene


Combined positive score


Disease-free survival


Dose-limiting toxicities


Event-free survival


Estrogen receptor


US Food and Drug Administration


Human epidermal growth factor receptor 2


Immune checkpoint inhibitor


Immune cells




Lactate dehydrogenase


Mitogen-activated protein kinase kinase


Metastatic triple-negative breast cancer


Objective response rate


Overall survival


Pathological complete response


Programmed cell death ligand 1


Progression-free survival


Progesterone receptor


Tumour-infiltrating lymphocytes


Tumour mutational burden


Triple-negative breast cancer


Treatment-related adverse events


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Dorota Kwapisz—conception and design/idea for the article, acquisition of data/literature search, analysis and interpretation of data, wrote the paper, critically revised the work, approval of the final version of the manuscript.

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Correspondence to Dorota Kwapisz.

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Kwapisz, D. Pembrolizumab and atezolizumab in triple-negative breast cancer. Cancer Immunol Immunother 70, 607–617 (2021).

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