Meta-analysis finds immunotherapy plus chemotherapy improves outcomes in triple-negative breast cancer

This meta-analysis examined outcomes for triple-negative breast cancer patients receiving immunotherapy combined with chemotherapy versus chemotherapy alone in neoadjuvant and adjuvant settings. The analysis included multiple studies, though the total sample size and follow-up duration were not reported. The primary outcome was pathological complete response, with secondary outcomes including progression-free survival, overall survival, event-free survival, and adverse events.

In the neoadjuvant setting, immunotherapy plus chemotherapy significantly improved pathological complete response compared to chemotherapy alone, with an odds ratio of 1.90. Event-free survival was also improved, with a hazard ratio of 0.65. The benefit for pathological complete response was observed in both PD-L1-positive patients and PD-L1-negative patients, with odds ratios of 1.65 and 1.56, respectively.

In the adjuvant setting, progression-free survival was prolonged in the intention-to-treat population, with a hazard ratio of 0.82. The benefit was more pronounced in PD-L1-positive subgroups, with a hazard ratio of 0.71. Safety data indicated an increased incidence of any-grade adverse events in the neoadjuvant setting, though specific rates were not reported.

Key limitations include the lack of reported absolute numbers, sample size, and follow-up duration. The analysis combined different immunotherapy agents and chemotherapy regimens. For clinical practice, these findings reinforce the potential benefit of immunotherapy combinations in triple-negative breast cancer, particularly in neoadjuvant settings, while highlighting the need to balance efficacy with the increased risk of adverse events.