Division of Early Drug Development for Innovative Therapies, Istituto Europeo di Oncologia, Milan, Italy.
Curr Opin Oncol. 2013 Nov;25(6):602-8. doi: 10.1097/CCO.0000000000000020.
We review recent advances leading to a new understanding of immunology of breast cancer with its potential clinical applications.
With the exception of antibody-based HER2 targeting, immunotherapy in breast cancer has largely been an unsatisfying experience. To improve the efficacy of breast cancer immunotherapeutics, a better understanding of the relation between innate and adaptive immune responses, of the immune escape mechanisms, the discovery of mechanisms underlying immunological tolerance, and the acknowledgment of the importance of both cell-mediated and humoral adaptive immunity for the control of tumor growth are needed.
Cancer takes advantage of the ability to hide from the immune system by exploiting a series of immune escape mechanisms. Among these mechanisms are the hijackings of immune cell-intrinsic checkpoints that are induced on T-cell activation. Blockade of these checkpoints - cytotoxic T-lymphocyte-associated antigen 4 or the programmed death 1 receptor - recently provided the first evidence of activity of an immune-modulation approach in the treatment of solid tumors. The future frontier in the immunotherapeutics of breast cancer requires identification of predictive factors. The immune system remembers what it targets, so once the system is correctly activated, it may mediate a long-lasting tumor response.
我们回顾了近年来在乳腺癌免疫学方面的新进展，及其潜在的临床应用。
除了基于抗体的 HER2 靶向治疗外，乳腺癌的免疫疗法在很大程度上一直令人不满意。为了提高乳腺癌免疫治疗的疗效，需要更好地理解先天免疫和适应性免疫反应之间的关系、免疫逃逸机制、免疫耐受机制的发现，以及认识到细胞介导和体液适应性免疫对于控制肿瘤生长的重要性。
癌症利用了一系列免疫逃逸机制，从而能够躲避免疫系统。这些机制包括劫持 T 细胞激活时诱导的免疫细胞内在检查点。最近，阻断这些检查点（细胞毒性 T 淋巴细胞相关抗原 4 或程序性死亡受体 1）为在实体瘤治疗中采用免疫调节方法提供了首个活性证据。乳腺癌免疫治疗的未来前沿需要确定预测因素。免疫系统会记住它所针对的目标，因此一旦系统被正确激活，它可能会介导持久的肿瘤反应。
