de la Cruz-Merino L, Chiesa M, Caballero R, Rojo F, Palazón N, Carrasco F H, Sánchez-Margalet V
Hospital Universitario Virgen Macarena, Seville, Spain.
GEICAM (Spanish Breast Cancer Research Group), Madrid, Spain.
Int Rev Cell Mol Biol. 2017;331:1-53. doi: 10.1016/bs.ircmb.2016.09.008. Epub 2016 Dec 2.
Cancer immunology has gained renewed interest in the past few years due to emerging findings on mechanisms involved in tumoral immune evasion. Indisputably, immune edition is currently considered a critical hallmark of cancer. Basic research has revealed new targets which can be modulated in the clinical setting with new compounds and strategies. As recent evidence confirms, breast cancer (BC) is a complex and heterogeneous disease in which host immune responses play a substantial role. T-infiltrating lymphocytes measurement is suggested as a powerful new tool necessary to predict early BC evolution, especially in HER2-positive and triple negative subtypes. However, T-infiltrating lymphocytes, genomic platforms, and many other biomarkers in tissue and peripheral blood (e.g., regulatory T cells and myeloid-derived suppressor cells) are not the only factors being evaluated regarding their potential role as prognostic and/or predictive factors. Many ongoing clinical trials are exploring the activity of immune checkpoint modulators in BC treatment, both in the advanced and neoadjuvant setting. Although this field is expanding with exciting new discoveries and promising clinical results-and creating great expectations-there remain many uncertainties yet to be addressed satisfactorily before this long awaited therapeutic promise can come to fruition.
由于在肿瘤免疫逃逸机制方面的新发现,癌症免疫学在过去几年中重新引起了人们的关注。毫无疑问,免疫编辑目前被认为是癌症的一个关键标志。基础研究已经揭示了新的靶点,这些靶点可以在临床环境中通过新的化合物和策略进行调节。最近的证据证实,乳腺癌(BC)是一种复杂的异质性疾病,宿主免疫反应在其中起着重要作用。浸润性T淋巴细胞测量被认为是预测早期BC进展的一种强大的新工具,特别是在HER2阳性和三阴性亚型中。然而,浸润性T淋巴细胞、基因组平台以及组织和外周血中的许多其他生物标志物(如调节性T细胞和髓系来源的抑制性细胞)并不是唯一被评估其作为预后和/或预测因素潜在作用的因素。许多正在进行的临床试验正在探索免疫检查点调节剂在BC治疗中的活性,包括晚期和新辅助治疗。尽管这个领域随着令人兴奋的新发现和有前景的临床结果而不断扩展,并带来了巨大的期望,但在这个期待已久的治疗前景实现之前,仍有许多不确定性需要令人满意地解决。