Bertucci François, Gonçalves Anthony
Department of Medical Oncology, Institut Paoli-Calmettes, 232 Bd. Ste-Marguerite, 13009, Marseille, France.
Department of Molecular Oncology, Centre de Recherche en Cancérologie de Marseille (CRCM), CNRS U7258, INSERM U1068, Marseille, France.
Curr Oncol Rep. 2017 Aug 10;19(10):64. doi: 10.1007/s11912-017-0627-0.
The purpose of the review is to summarize the data regarding PD-L1 expression in breast cancer and the results of first clinical trials with PD-1 or PD-L1 inhibitors in patients with metastatic breast cancer.
PD-L1 expression is heterogeneous across primary breast cancers, and is generally associated with the presence of tumor-infiltrating lymphocytes and the presence of poor-prognosis features such as high grade, and aggressive molecular subtypes (triple-negative (TN), basal, HER2-enriched). Early phase clinical trials using PD-1 or PD-L1 inhibitors alone or in combination have shown objective tumor responses and durable long-term disease control, in heavily pre-treated patients, notably in the TN subtype. Blockade of PD-1 or PD-L1 shows impressive antitumor activity in some subsets of breast cancer patients. Many clinical trials are ongoing in the metastatic and neoadjuvant setting, alone and in combination with chemotherapy, targeted therapy, radiotherapy, and/or other immune therapy. The identification of biomarkers predictive for a clinical benefit is warranted.
本综述旨在总结有关乳腺癌中程序性死亡配体1（PD-L1）表达的数据，以及转移性乳腺癌患者使用程序性死亡受体1（PD-1）或PD-L1抑制剂的首批临床试验结果。
原发性乳腺癌中PD-L1表达具有异质性，通常与肿瘤浸润淋巴细胞的存在以及高分级和侵袭性分子亚型（三阴性（TN）、基底样、人表皮生长因子受体2（HER2）富集型）等预后不良特征相关。单独或联合使用PD-1或PD-L1抑制剂的早期临床试验已显示，在经过大量预处理的患者中，尤其是TN亚型患者，出现了客观的肿瘤反应和持久的长期疾病控制。阻断PD-1或PD-L1在某些乳腺癌患者亚组中显示出令人印象深刻的抗肿瘤活性。许多转移性和新辅助治疗环境下的临床试验正在进行，单独或与化疗、靶向治疗、放疗和/或其他免疫治疗联合使用。确定预测临床获益的生物标志物很有必要。
