Department of General Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, 03001, China.
Department of Medicine, The Penn State Cancer Institute, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
Drug Resist Updat. 2017 May;32:1-15. doi: 10.1016/j.drup.2017.07.002. Epub 2017 Aug 19.
Patients with breast tumors that do not express the estrogen receptor, the progesterone receptor, nor Her-2/neu are hence termed "triple negatives", and generally have a poor prognosis, with high rates of systemic recurrence and refractoriness to conventional therapy regardless of the choice of adjuvant treatment. Thus, more effective therapeutic options are sorely needed for triple-negative breast cancer (TNBC), which occurs in approximately 20% of diagnosed breast cancers. In recent years, exploiting intrinsic mechanisms of the host immune system to eradicate cancer cells has achieved impressive success, and the advances in immunotherapy have yielded potential new therapeutic strategies for the treatment of this devastating subtype of breast cancer. It is anticipated that the responses initiated by immunotherapeutic interventions will explicitly target and annihilate tumor cells, while at the same time spare normal cells. Various immunotherapeutic approaches have been already developed and tested, which include the blockade of immune checkpoints using neutralizing or blocking antibodies, induction of cytotoxic T lymphocytes (CTLs), adoptive cell transfer-based therapy, and modulation of the tumor microenvironment to enhance the activity of CTLs. One of the most important areas of breast cancer research today is understanding the immune features and profiles of TNBC and devising novel immune-modulatory strategies to tackling TNBC, a subtype of breast cancer notorious for its poor prognosis and its imperviousness to conventional treatments. On the optimal side, one can anticipate that novel, effective, and personalized immunotherapy for TNBC will soon achieve more success and impact clinical treatment of this disease which afflicts approximately 20% of patients with breast cancer. In the present review, we highlight the current progress and encouraging developments in cancer immunotherapy, with a goal to discuss the challenges and to provide future perspectives on how to exploit a variety of new immunotherapeutic approaches including checkpoint inhibitors and neoadjuvant immunotherapy for the treatment of patients with TNBC.
患有不表达雌激素受体、孕激素受体和 Her-2/neu 的乳腺肿瘤的患者因此被称为“三阴性”，一般预后较差，全身性复发率较高，对常规治疗具有耐药性，无论选择何种辅助治疗。因此，三阴性乳腺癌（TNBC）迫切需要更有效的治疗选择，TNBC 约占诊断出的乳腺癌的 20%。近年来，利用宿主免疫系统的内在机制来消灭癌细胞已取得令人瞩目的成功，免疫疗法的进展为治疗这种毁灭性的乳腺癌亚型提供了潜在的新治疗策略。预计免疫治疗干预引发的反应将明确针对并消灭肿瘤细胞，同时保留正常细胞。已经开发并测试了各种免疫治疗方法，包括使用中和或阻断抗体阻断免疫检查点、诱导细胞毒性 T 淋巴细胞（CTL）、过继细胞转移治疗和调节肿瘤微环境以增强 CTL 活性。当今乳腺癌研究的最重要领域之一是了解 TNBC 的免疫特征和特征，并设计新的免疫调节策略来应对 TNBC，这种乳腺癌亚型以预后不良和对常规治疗耐药而闻名。在最佳情况下，人们可以预期针对 TNBC 的新型、有效和个性化免疫疗法将很快取得更大的成功，并影响这种影响约 20%乳腺癌患者的疾病的临床治疗。在本综述中，我们强调了癌症免疫疗法的当前进展和令人鼓舞的发展，旨在讨论挑战，并提供未来的观点，探讨如何利用各种新的免疫治疗方法，包括检查点抑制剂和新辅助免疫疗法，来治疗 TNBC 患者。
