G Curigliano MD PhD Profile picture
Oct 31, 2022 12 tweets 5 min read Read on X
Sponsored by @Roche,
I would like to share a Tweetorial about recent important advances in the management of advanced/metastatic triple negative breast cancer (mTNBC)

#Tweetorial #Oncology #Cancer #Diagnosis #TNBC #Immunotherapy #PDL1
TNBC is a challenging disease to treat due to its aggressive behavior, heterogeneity, and the lack of universal actionable targets. mTNBC is commonly diagnosed at a younger age than other BC subtypes and its prognosis is poor, with a median survival of <2 years.
Advanced TNBC can result from recurrence after treatment in the early-stage disease setting, or it may be diagnosed at initial (de novo) presentation
The emergence of cancer immunotherapy, including immune checkpoint inhibitors (ICIs), is revolutionizing the way we treat mTNBC. In mTNBC, first-line ICI + chemotherapy combinations improved survival outcomes in patients with PD-L1+ (programmed death ligand-1-positive) disease Image
ICIs in combination with chemotherapy are approved (subject to location) and now considered standard of care for first-line treatment of advanced-stage, PD-L1+ TNBC
Trials for the different ICIs have assessed PD-L1 expression in various ways including different types of cells (tumor cells / immune cells / both), detection antibodies, scoring algorithms, and positivity cutoffs.

This has to be considered when determining patient eligibility
Assuming approved assays are available, how should we assess patient eligibility to receive an ICI-based regimen?
We need to understand the nuances of detecting PD-L1 expression and work closely with our pathologist colleagues on this matter.
We also need additional biomarkers to help identify patients who will benefit most from ICI therapy, while excluding patients who won't

This will prevent unnecessary exposure and contribute to our healthcare system's sustainability
Other novel anticancer drugs are emerging for the treatment of TNBC, contributing to improved outcomes and making the treatment landscape increasingly complex
To summarize, we have a long way to go, but novel therapies are changing how we manage this challenging disease

Here are the latest ESMO guidelines for the management of BC:
esmo.org/guidelines/gui…
I hope you found this tweetorial interesting. Would you like to see further tweetorials detailing recent advances in oncology management within areas of unmet need?
#Tweetorial #Oncology #Cancer #Diagnosis #Immunotherapy

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