Immunotherapy in the neoadjuvant treatment of hormone receptor-positive/HER2-negative early breast cancer: novel approaches and future perspectives

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PURPOSE OF REVIEW: To summarize recent advances and emerging strategies for integrating immunotherapy into the neoadjuvant treatment of patients with hormone receptor (HR)-positive/HER2-negative early breast cancer (eBC). This review explores how combining immune checkpoint inhibitors (ICIs) with standard treatments and/or novel strategies may potentially improve responses and long-term outcomes. RECENT FINDINGS: Recent clinical trials have demonstrated that adding ICIs to standard neoadjuvant chemotherapy in HR-positive eBC significantly increases pathological complete response (pCR) rates. However, this benefit should be balanced against an increase in side effects, particularly those immune-mediated. Innovative approaches, such as incorporating radiation therapy to neoadjuvant treatments and ICIs have shown promise in enhancing immune responses, potentially overcoming the lower immunogenicity of luminal-like eBC. SUMMARY: The integration of immunotherapy into neoadjuvant regimens offers a promising strategy to improve outcomes in HR-positive/HER2-negative eBC. While increased pCR rates are encouraging, further research with longer follow-up is necessary to establish the impact on long-term survival. Optimizing patient selection through robust predictive biomarkers and refining combination strategies will be crucial to maximize clinical benefit while minimizing toxicity.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.