Immunotherapy combined with chemotherapy and anti-angiogenic therapy for advanced triple-negative breast cancer after multiline failure: a case report and literature review

Objectives Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer, and patients with advanced TNBC who have failed multi-line treatment often face limited therapeutic options and poor prognosis. This case report presents the clinical efficacy of immunotherapy combined with chemotherapy and anti-angiogenic therapy in a patient with advanced TNBC after multi-line treatment failure and provides a reference for therapeutic decision-making in similar cases. Case presentation We report a case of advanced TNBC in a patient who had undergone extensive prior treatment, including multiple lines of therapy (≥7), yet failed to achieve a sustained clinical response. After progression on tislelizumab plus chemotherapy, the patient again responded to pembrolizumab combined with bevacizumab and chemotherapy during the eighth line of treatment, achieving significant tumour shrinkage that has remained stable for 10 months. Several months later, the patient discontinued pembrolizumab due to immune-related pneumonia. Bevacizumab and pemetrexed were continued until disease progression, ultimately achieving a total progression-free survival (PFS) of nearly 24 months. Conclusions Immunotherapy combined with chemotherapy and anti-angiogenic therapy may exhibit significant clinical efficacy in patients with advanced TNBC who have experienced multi-line treatment failure.