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乳腺癌免疫治疗

英文原题:Immunotherapy in Breast Cancer.

PubMed 2024/07/09(内容时间) Int J Mol Sci Q1 · IF 5.6(JCR 2025)

研究概要

乳腺癌是一种涵盖多种分子亚型和临床表现的疾病,每种亚型都具有独特的预后意义和治疗反应。

中文摘要

乳腺癌是一种涵盖多种分子亚型和临床表现的疾病,每种亚型具有不同的预后意义和治疗反应。乳腺癌传统上被认为是一种免疫“冷”肿瘤,对免疫治疗无反应。然而,近年来的临床试验发现免疫治疗对部分患者是一种有效的治疗选择。乳腺癌被分为不同的亚型,从最常见的激素受体(HR)阳性、人表皮生长因子受体2(HER2)阴性型,到较少见的HER2阳性乳腺癌和三阴性乳腺癌(TNBC),凸显了制定个体化治疗策略以最大化患者获益的必要性。尽管在早期检测和新型治疗手段方面取得了显著进展,乳腺癌仍然是美国癌症死亡的第二大原因。此外,近几十年来,乳腺癌发病率持续上升,尤其是在50岁以下的女性中。这促使人们探索新的治疗方法以应对这一趋势,为乳腺癌患者提供了新的治疗前景。免疫治疗是一类已经彻底改变了许多癌症治疗格局的治疗药物,即黑色素瘤、肺癌和胃食管癌等。尽管姗姗来迟,免疫治疗已进入乳腺癌的治疗武器库,pembrolizumab联合化疗已获批用于三阴性乳腺癌(TNBC)的新辅助和晚期治疗,从而为进一步研究和将免疫检查点抑制剂整合到其他乳腺癌亚型中铺平了道路。探索各种联合疗法的试验正在进行中,旨在将免疫疗法的力量与多种化疗药物协同作用,以期提高乳腺癌患者的缓解率并延长生存期。生物标志物和精确的患者选择对于免疫疗法的应用仍然至关重要,目前正在研究中,一些生物标志物显示出前景,如 Program Death Lignat-1 (PDL-1) Combined Positive Score、Tumor Mutation Burden (TMB) 和 Tumor Infiltrating Lymphocytes (TILs)。本综述将介绍免疫疗法,特别是检查点抑制剂,在不同类型乳腺癌中的当前格局。

展开英文摘要原文

Breast cancer is a disease encompassing a spectrum of molecular subtypes and clinical presentations, each with distinct prognostic implications and treatment responses. Breast cancer has traditionally been considered an immunologically "cold" tumor, unresponsive to immunotherapy. However, clinical trials in recent years have found immunotherapy to be an efficacious therapeutic option for select patients. Breast cancer is categorized into different subtypes ranging from the most common positive hormone receptor (HR+), human epidermal growth factor receptor 2 (HER2)-negative type, to less frequent HER2- positive breast cancer and triple-negative breast cancer (TNBC), highlighting the necessity for tailored treatment strategies aimed at maximizing patient outcomes. Despite notable progress in early detection and new therapeutic modalities, breast cancer remains the second leading cause of cancer death in the USA. Moreover, in recent decades, breast cancer incidence rates have been increasing, especially in women younger than the age of 50. This has prompted the exploration of new therapeutic approaches to address this trend, offering new therapeutic prospects for breast cancer patients. Immunotherapy is a class of therapeutic agents that has revolutionized the treatment landscape of many cancers, namely melanoma, lung cancer, and gastroesophageal cancers, amongst others. Though belatedly, immunotherapy has entered the treatment armamentarium of breast cancer, with the approval of pembrolizumab in combination with chemotherapy in triple-negative breast cancer (TNBC) in the neoadjuvant and advanced settings, thereby paving the path for further research and integration of immune checkpoint inhibitors in other subtypes of breast cancer. Trials exploring various combination therapies to harness the power of immunotherapy in symbiosis with various chemotherapeutic agents are ongoing in hopes of improving response rates and prolonging survival for breast cancer patients. Biomarkers and precise patient selection for the utilization of immunotherapy remain cardinal and are currently under investigation, with some biomarkers showing promise, such as Program Death Lignat-1 (PDL-1) Combined Positive Score, Tumor Mutation Burden (TMB), and Tumor Infiltrating Lymphocytes (TILs). This review will present the current landscape of immunotherapy, particularly checkpoint inhibitors, in different types of breast cancer.

论文信息

作者
Dvir K、Giordano S、Leone JP
单位
Dana Farber Cancer Institute, Boston, MA 02215, USA.United States
文献类型
综述
期刊
International journal of molecular sciences2024 Jul 9
原文标识
PubMed 39062758 · DOI 10.3390/ijms25147517