Evaluating the efficacy and safety of first-line immunotherapy for metastatic triple-negative breast cancer: a systematic review and network meta-analysis of randomized controlled trials with a focus on PD-L1 expression

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This systematic review evaluated first-line immunotherapy for metastatic triple-negative breast cancer (mTNBC) through a Bayesian network meta-analysis.
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The combination of immune checkpoint inhibitors (ICIs) with chemotherapy significantly improved overall survival (OS) and progression-free survival (PFS) compared to chemotherapy alone.
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In patients with PD-L1 expression ≥1%, ICIs combined with chemotherapy showed marked improvements in OS and PFS, with even greater benefits in those with PD-L1 ≥10%.
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Toripalimab combined with chemotherapy demonstrated the greatest OS benefit in the overall mTNBC population, while Pembrolizumab showed the best safety profile.
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The findings suggest that Toripalimab and Pembrolizumab may be suitable first-line treatment options for mTNBC, especially for PD-L1 positive patients.

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