St Bartholomew's Hospital, London, UK.
St Bartholomew's Hospital, London, UK.
Breast. 2018 Feb;37:200-206. doi: 10.1016/j.breast.2017.05.013. Epub 2017 Jun 2.
Over the last few years, the developments around cancer immunotherapy (CIT) have led to a paradigm shift in the treatment of many different cancers, in particular melanoma, renal, bladder and lung cancers with a remarkable impact on response rate and, most importantly, overall survival. Breast cancer is most commonly considered to be a 'non-inflamed' cancer and so this shift has been less marked within its treatment. However, some subsets of breast cancer, most notably triple negative breast cancer, are deemed to be more 'inflamed' and therefore may prove to be an appropriate cohort for CIT. This review looks back at the theory of the cancer immunity cycle and mechanism of action behind immune checkpoint inhibitors and goes on to explore their role within the various subtypes of breast cancer. It looks at the first trials performed using CIT monotherapy which demonstrated that breast cancer could respond to CIT with a small population reaping considerable benefit. It then examines the continuing body of work being undertaken to explore CIT in combination with chemotherapy to try to increase the proportion of patients who might reap the considerable rewards on offer.
在过去的几年中，癌症免疫疗法 (CIT) 的发展导致了许多不同癌症治疗方式的范式转变，特别是黑色素瘤、肾细胞癌、膀胱癌和肺癌，这对反应率产生了显著影响，最重要的是对总生存率产生了显著影响。乳腺癌通常被认为是一种“非炎症性”癌症，因此在其治疗中这种转变并不明显。然而，乳腺癌的一些亚组，尤其是三阴性乳腺癌，被认为更具“炎症性”，因此可能被证明是 CIT 的合适队列。本综述回顾了癌症免疫循环理论和免疫检查点抑制剂的作用机制，并探讨了它们在各种乳腺癌亚型中的作用。它考察了首次使用 CIT 单药治疗进行的试验，这些试验表明乳腺癌可以对 CIT 产生反应，一小部分患者从中获得了相当大的益处。然后，它检查了正在进行的大量工作，以探索 CIT 与化疗联合使用，以试图增加可能从提供的可观回报中受益的患者比例。
