Stefanovic Stefan, Schuetz Florian, Sohn Christof, Beckhove Philipp, Domschke Christoph
Department of Gynecology and Obstetrics, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany.
Cancer Metastasis Rev. 2014 Mar;33(1):309-20. doi: 10.1007/s10555-013-9452-6.
Breast cancer is a systemic disease with a primarily local component. Besides surgical resection and irradiation of the locoregional tumor setting, central therapeutic aim is the elimination of disseminated micrometastatic tumor cells using cytostatic and/or hormonal treatment. Nevertheless, in the course of time a majority of patients suffer from systemic recurrence in the form of distant metastases. Intriguingly, in this connection, intratumoral cytotoxic T lymphocytes might serve as independent predictors of treatment efficacy and clinical outcome. Loss of immune balance (tumor dormancy) during intensive cross talk between T cells and tumor cells in the bone marrow microenvironment is suggested one reason for distant metastatic relapse. In this clinical context, further supportive therapies become increasingly attractive, taking immunological features of breast cancer cells into special account. The present review aims to dissect bone marrow-derived cellular antitumor immune responses and translational immunologic treatment options regarding their actual relevance to patients' clinical benefit and their future directions in breast cancer management.
乳腺癌是一种主要具有局部成分的全身性疾病。除了对局部区域肿瘤进行手术切除和放疗外，核心治疗目标是使用细胞毒性药物和/或激素治疗来消除播散的微转移肿瘤细胞。然而，随着时间的推移，大多数患者会出现远处转移形式的全身复发。有趣的是，在这方面，肿瘤内细胞毒性T淋巴细胞可能作为治疗效果和临床结局的独立预测指标。骨髓微环境中T细胞与肿瘤细胞之间的密集相互作用过程中免疫平衡的丧失（肿瘤休眠）被认为是远处转移复发的一个原因。在这种临床背景下，考虑到乳腺癌细胞的免疫学特征，进一步的支持性治疗变得越来越有吸引力。本综述旨在剖析源自骨髓的细胞抗肿瘤免疫反应以及转化性免疫治疗选择，涉及其与患者临床获益的实际相关性以及它们在乳腺癌管理中的未来方向。
