Atezolizumab Treatment for TNBC

Despite remarkable success of immune checkpoint blockade with chemotherapy, their efficacies in triple negative breast cancer (TNBC) are controversial. We utilized a non-invasive metabolomic and proteomic approach to comprehensively profile serum metabolites and proteins in 20 advanced TNBC patients treated with paclitaxel or its combination with atezolizumab, an antibody against programmed cell death protein 1 ligand 1(PDL1). In total, 1441 metabolites and 1254 proteins were quantified in patient sera at baseline, 4 weeks after treatment initiation, and disease progression. We found that high levels of lipids, tricarboxylic acid cycle (TCA) intermediates and free fatty acids at baseline could predict effective responses to the combination therapy. Notably, lipids exhibited dramatic decline following atezolizumab treatment, but instead showed increase after paclitaxel treatment. Our data point to new ways of targeting metabolic reprogramming to improve the efficacy of cancer immune intervention therapy.