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早期三阴性乳腺癌的新辅助免疫治疗:迎头赶上

英文原题:Neoadjuvant Immunotherapy in Early, Triple-Negative Breast Cancers: Catching Up with the Rest.

查看英文原题

Neoadjuvant Immunotherapy in Early, Triple-Negative Breast Cancers: Catching Up with the Rest.

PubMed 2023/06/22(内容时间) Ann Surg Oncol Q1 · IF 3.8(JCR 2025)

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中文摘要

尽管乳腺癌长期被认为是“免疫冷”肿瘤,但在早期三阴性乳腺癌(TNBC)中,免疫检查点调节联合新辅助化疗已取得令人振奋的进展。本文综述了研究新辅助化学免疫联合治疗的主要临床试验,回顾病理学完全缓解率以及正在成熟的无事件生存期和总生存期数据。下一代挑战包括:为临床结局依旧优异的患者探索降低辅助治疗强度的策略,以及为存在大量残留病灶的患者探索改善结局的辅助联合治疗。除完善PD-L1、TIL(肿瘤浸润淋巴细胞)和肿瘤突变负荷(TMB)等现有生物标志物外,微生物组作为生物标志物和治疗手段在其他癌种中的研究已显示前景,也促使研究者进一步在乳腺癌中开展探索。

展开英文摘要原文

Despite breast cancer being long thought to be "immunologically cold," within early, triple-negative breast cancer (TNBC), there has been exciting advances with the use of immune checkpoint modulation combined with neoadjuvant chemotherapy.

We review the major trials that have investigated combination immunochemotherapy in the neoadjuvant setting, reviewing both the pathological complete response rates and the maturing data regarding event-free and overall survival. Strategies to deescalate adjuvant therapy in patients with preserving excellent clinical outcome, as well as exploration of combinatorial adjuvant therapies to improve outcome in those with extensive residual are the next-generation challenges.

In addition to refinement of existing biomarkers, such as PD-L1, TILs, and tumor mutational burden (TMB), exploration of topics like the microbiome as both a biomarker and a therapeutic has shown promise in other cancer types, which motivates investigating these in breast cancer.

论文信息

作者
Kim L、Coman M、Pusztai L、Park TS
第一作者单位
Section of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.United States
通讯作者单位
Section of Surgical Oncology, Department of Surgery, Yale School of Medicine, New Haven, CT, USA. tristen.park@yale.edu.United States
文献类型
综述
期刊
Annals of surgical oncology2023 Oct
原文标识
PubMed 37349612 · DOI 10.1245/s10434-023-13714-x