Pusztai Lajos, Karn Thomas, Safonov Anton, Abu-Khalaf Maysa M, Bianchini Giampaolo
Breast Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, Connecticut.
Department of Obstetrics and Gynecology, Goethe-University Frankfurt, Frankfurt am Main, Germany.
Clin Cancer Res. 2016 May 1;22(9):2105-10. doi: 10.1158/1078-0432.CCR-15-1315. Epub 2016 Feb 11.
More than 70% of breast cancers contain lymphocytic infiltration in the stroma, and preclinical studies suggest that immunoediting and partial control of cancer progression by the local immune microenvironment operate in most breast cancers. Consistent with this hypothesis, a large number of studies demonstrated a favorable prognostic and chemotherapy response predictive role for immune infiltration in breast cancer. The evidence is particularly strong for triple-negative and HER2-positive cancers. The development of clinically effective immune checkpoint inhibitors now provides an opportunity to test the therapeutic potential of augmenting the local antitumor immune response. Several phase I clinical trials using single-agent anti-PD-1 and anti-PD-L1 antibodies demonstrated objective tumor response rates, with remarkably durable responses, in heavily pretreated, metastatic, triple-negative cancers and somewhat lower responses in estrogen receptor-positive cancers. Currently, close to 50 ongoing, or soon to open, clinical trials evaluate the role of this new treatment modality in breast cancer. Clin Cancer Res; 22(9); 2105-10. ©2016 AACR.
超过70%的乳腺癌在间质中存在淋巴细胞浸润，临床前研究表明，免疫编辑以及局部免疫微环境对癌症进展的部分控制作用存在于大多数乳腺癌中。与这一假设一致的是，大量研究证明免疫浸润在乳腺癌中具有良好的预后和化疗反应预测作用。对于三阴性和HER2阳性癌症，这一证据尤为有力。目前临床上有效的免疫检查点抑制剂的开发为测试增强局部抗肿瘤免疫反应的治疗潜力提供了机会。几项使用单药抗PD-1和抗PD-L1抗体的I期临床试验显示，在经过大量预处理的转移性三阴性癌症中出现了客观肿瘤反应率，且反应持续时间显著，而在雌激素受体阳性癌症中的反应则略低。目前，近50项正在进行或即将开展的临床试验正在评估这种新治疗方式在乳腺癌中的作用。《临床癌症研究》；22(9)；2105 - 2110。©2016美国癌症研究协会。
