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三阴性乳腺癌免疫治疗的进展与展望

英文原题:Progress and Prospect of Immunotherapy for Triple-Negative Breast Cancer.

PubMed 2022/06/20(内容时间) Front Oncol Q2 · IF 3.4(JCR 2025)

研究概要

TNBC仅占新发乳腺癌诊断的约15%-20%;

中文摘要

乳腺癌是女性最常见确诊癌症,2020年估计新增230万病例,也是女性癌症死亡的首要原因,2020年估计死亡68.5万人。根据雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)等经典激素及生长因子受体的免疫组化表达,以及增殖标志物Ki-67表达,乳腺癌分为四种主要分子亚型。三阴性乳腺癌(TNBC)缺乏ER、PR和HER2表达,具有较高转移潜力和较差预后。TNBC约占新诊断乳腺癌的15%至20%,由于缺少靶向治疗,多数乳腺癌相关死亡发生于该亚型患者;目前其主要治疗方式仍为全身化疗、放疗和手术切除。总体而言,乳腺癌患者对免疫疗法应答不强,但部分TNBC具有高肿瘤突变负荷和高TIL水平,类似黑色素瘤或肺癌特征,可从免疫检查点抑制剂(ICI)治疗中获益。这种侵袭性疾病的免疫原性为开发TNBC靶向免疫疗法提供了机会。美国FDA近期批准阿替利珠单抗联合白蛋白结合型紫杉醇,用于PD-L1阳性、不可切除局部晚期或转移性TNBC,开启了TNBC免疫治疗新时代。本综述进一步介绍临床前研究新发现和临床试验早期结果,涵盖细胞因子、单克隆抗体、抗体药物偶联物、双/三特异性抗体、ICI和新抗原癌症疫苗等免疫分子疗法,溶瘤病毒疗法,以及TIL、CAR-T、CAR-NK、CAR-巨噬细胞和TCR-T等过继免疫细胞转输疗法。最后总结免疫治疗未来挑战和机遇,并介绍高通量单细胞测序、基于CRISPR基因编辑的筛选等新技术如何帮助产生免疫疗法新认识。

展开英文摘要原文

Breast cancer is the most commonly diagnosed cancer (estimated 2.3 million new cases in 2020) and the leading cause of cancer death (estimated 685,000 deaths in 2020) in women globally. Breast cancers have been categorized into four major molecular subtypes based on the immunohistochemistry (IHC) expression of classic hormone and growth factor receptors including the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), as well as a proliferation marker Ki-67 protein expression. Triple-negative breast cancer (TNBC), a breast cancer subtype lacking ER, PR, and HER2 expression, is associated with a high metastatic potential and poor prognosis. TNBC accounts for approximately only 15%-20% of new breast cancer diagnoses; it is responsible for most breast cancer-related deaths due to the lack of targeted treatment options for this patient population, and currently, systemic chemotherapy, radiation, and surgical excision remain the major treatment modalities for these patients with TNBC. Although breast cancer patients in general do not have a robust response to the immunotherapy, a subset of TNBC has been demonstrated to have high tumor mutation burden and high tumor-infiltrating lymphocytes, resembling the features observed on melanoma or lung cancers, which can benefit from the treatment of immune checkpoint inhibitors (ICIs). Therefore, the immunogenic nature of this aggressive disease has presented an opportunity for the development of TNBC-targeting immunotherapies. The recent US Food and Drug Administration approval of atezolizumab in combination with the chemotherapeutic agent nab-paclitaxel for the treatment of PD-L1-positive unresectable, locally advanced, or metastatic TNBC has led to a new era of immunotherapy in TNBC treatment. In addition, immunotherapy becomes an active research area, both in the cancer biology field and in the oncology field. In this review, we will extend our coverage on recent discoveries in preclinical research and early results in clinical trials from immune molecule-based therapy including cytokines, monoclonal antibodies, antibody-drug conjugates, bi-specific or tri-specific antibodies, ICIs, and neoantigen cancer vaccines; oncolytic virus-based therapies and adoptive immune cell transfer-based therapies including TIL, chimeric antigen receptor-T (CAR-T), CAR-NK, CAR-M, and T-cell receptor-T. In the end, we will list a series of the challenges and opportunities in immunotherapy prospectively and reveal novel technologies such as high-throughput single-cell sequencing and CRISPR gene editing-based screening to generate new knowledges of immunotherapy.

论文信息

作者
Luo C、Wang P、He S、Zhu J、Shi Y、Wang J
单位
School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China.China
文献类型
综述
期刊
Frontiers in oncology2022
原文标识
PubMed 35795050 · DOI 10.3389/fonc.2022.919072