Paolo Cotzia: Investigating the role of immunotherapy in metastatic inflammatory breast cancer
Paolo Cotzia, Medical Director of Molecular Pathology and Head of Molecular Excellence at Sonic Healthcare USA, posted the following on LinkedIn:
“Inflammatory breast cancer (IBC) is a very aggressive tumor and carries a 30% higher mortality than non-IBC.
Despite the higher mortality, patients with metastatic IBC (PD-L1)-positive, triple-negative IBC (mTN-IBC) are treated with first-line chemotherapy and immune checkpoint inhibitors (ICIs) applying the same therapeutic approaches used for non-IBC patients.
This interesting retrospective study evaluated ICIs therapy in patients with metastatic, triple-negative, primary Inflammatory Breast Carcinomas who received ICIs plus first-line chemotherapy from January 2015 to April 2023.
Data from 41 IBC patients was analyzed (61% with primary, de novo mTN-IBC, 61% with visceral disease). All patients received ICIs plus first-line chemotherapy and 24% underwent breast surgery and/or locoregional radiotherapy.
After a median follow-up of 19.3 months, the 6-months real-world progression-free survival (rwPFS) rate was 30% (95% Confidence Interval [CI], 17–45%), the median rwPFS was 3.3 months (95% CI: 2.2–5.4), and the median overall survival was 15.7 months (95% CI: 6.8–16.3).
This study demonstrated a poor outcome of patients with mTN-IBC, despite the treatment with ICI. This outcome is in contrast with the expected benefit based on preclinical evidence of immune-vulnerability of inflammatory breast cancer supported by expression of PD-L1 and the presence of tumor infiltrated lymphocytes (TILs).
The results discussed in the paper support the need to further investigate the role of immunotherapy in this aggressive and rare type of breast cancer presentation.”
Authors: Carmine Valenza, Dario Trapani, Paola Zagami, Gabriele Antonarelli, Luca Boscolo Bielo, Eleonora Nicolò, Joana Mourato Ribeiro, Lorenzo Guidi, Carolina Reduzzi, Martina Spotti, Laura Adamoli, Javier Cortès, Barbara Pistilli, Sara M. Tolaney, Naoto Ueno, Rachel M. Layman, Massimo Cristofanilli, Lisa A. Carey, Elisabetta Munzone, Carmen Criscitiello, Filipa Lynce, Wendy A. Woodward, Giuseppe Curigliano
Paolo Cotzia is the Medical Director of Molecular Pathology and Head of Molecular Excellence at Sonic Healthcare USA, as well as the Medical Director of Sonic Reference Laboratory. He is a board-certified pathologist specialized in oncologic surgical pathology and molecular genetics, with expertise in biomarker discovery, molecular diagnostics, digital pathology, AI, biobanking, and clinical trials.
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