Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France.
Clin Cancer Res. 2013 Jan 1;19(1):28-33. doi: 10.1158/1078-0432.CCR-11-2701. Epub 2012 Dec 20.
The immune system could mediate the antitumor activity of several anticancer treatments. Several chemotherapy compounds, including anthracyclines and oxaliplatin, induce immunogenic cell death that in turn activates antitumor immune response. Trastuzumab induces antibody-dependant cell-mediated cytotoxicity. On the basis of this background, immune markers have recently been the focus of intense translational research to predict and monitor the efficacy of treatments. Gene expression arrays and immunohistochemistry have assessed immune activation and infiltration by macrophages, natural killer, and T and B lymphocytes. Using these approaches, several retrospective analyses of large trials have shown that activation of immune pathway may predict treatment efficacy and outcome in patients with breast cancers. As examples, intratumoral infiltration by lymphocytes and interferon-response in primary tumor predicted the efficacy of neoadjuvant chemotherapy. Intratumoral infiltration by lymphocytes was associated with good prognosis in patients with triple-negative breast cancer treated with adjuvant chemotherapy. More recently, it has been suggested that lymphocyte infiltration could also predict efficacy of trastuzumab. Finally, small retrospective studies have suggested that postchemotherapy lymphocyte infiltrates could be associated with better outcome in patients who did not reach pathologic complete response. This body of evidence suggests that assessing immune infiltration and activation could be useful in the future to stratify breast cancer patients. In addition, they provide evidence for the development of immunotherapies in breast cancer patients.
免疫系统可能介导几种抗癌治疗的抗肿瘤活性。几种化疗药物，包括蒽环类药物和奥沙利铂，诱导免疫原性细胞死亡，进而激活抗肿瘤免疫反应。曲妥珠单抗诱导抗体依赖性细胞介导的细胞毒性。基于这一背景，免疫标志物最近成为密集转化研究的焦点，以预测和监测治疗的疗效。基因表达阵列和免疫组织化学评估了巨噬细胞、自然杀伤细胞以及 T 和 B 淋巴细胞的免疫激活和浸润。使用这些方法，几项大型试验的回顾性分析表明，免疫途径的激活可能预测乳腺癌患者的治疗效果和结局。例如，肿瘤内淋巴细胞浸润和原发性肿瘤中的干扰素反应预测了新辅助化疗的疗效。肿瘤内淋巴细胞浸润与接受辅助化疗的三阴性乳腺癌患者的良好预后相关。最近，有人提出淋巴细胞浸润也可能预测曲妥珠单抗的疗效。最后，一些小型回顾性研究表明，化疗后淋巴细胞浸润可能与未达到病理完全缓解的患者的更好结局相关。这一证据表明，评估免疫浸润和激活可能有助于未来对乳腺癌患者进行分层。此外，它们为乳腺癌患者的免疫治疗提供了依据。
