a School of Medical Oncology, Department of Medicine , University of Udine , Udine , Italy.
b Department of Oncology , University Hospital of Udine , Udine , Italy.
Expert Opin Biol Ther. 2018 May;18(5):595-603. doi: 10.1080/14712598.2018.1469619. Epub 2018 May 8.
Breast cancer (BC) is the most common cancer diagnosed among women. The development of new personalized therapeutic strategies has reshaped the landscape in this field. However, BC is still the first cause of death among women. Interestingly, several preclinical studies and some clinical evidences are focused their attention on the role of immune system and immunotherapy on cancer control, also in BC. Areas covered: Usually, BC has been considered a not immunogenic tumor for its low mutational load. However, recent studies have evidenced that some subtypes, triple negative and HER-2 positive BC, are 'hot' tumors, thus more immunogenic. Moreover, the presence of immune infiltrate is positively associated with favorable prognosis. Therefore, the use of immune-checkpoint inhibitors seems to be an encouraging treatment option also in BC. Among these drugs, atezolizumab is an anti-PD-L1 monoclonal antibody with a particular structure that reduce antibody-dependent cellular cytotoxicity against T cells, increasing quantitatively and qualitatively the effective response. Expert opinion: The use of immunotherapy is a promising option for BC. However, at the same time it still raises many doubts. Surely, the research and the validation of immune biomarkers can permit to identify patients who more benefit from these drugs.
乳腺癌（BC）是女性最常见的癌症诊断。新的个性化治疗策略的发展已经改变了这一领域的格局。然而，BC 仍然是女性死亡的第一大原因。有趣的是，一些临床前研究和一些临床证据都集中在免疫系统和免疫疗法在癌症控制中的作用上，包括在 BC 中。
通常，BC 由于其低突变负荷而被认为是一种非免疫原性肿瘤。然而，最近的研究表明，一些亚型，如三阴性和 HER-2 阳性 BC，是“热”肿瘤，因此更具免疫原性。此外，免疫浸润的存在与良好的预后呈正相关。因此，免疫检查点抑制剂的使用似乎也是 BC 的一种有前途的治疗选择。在这些药物中，阿特珠单抗是一种抗 PD-L1 单克隆抗体，具有特殊的结构，可以减少针对 T 细胞的抗体依赖性细胞毒性，从而增加有效反应的数量和质量。
免疫疗法是 BC 的一种有前途的选择。然而，与此同时，它仍然存在许多疑问。毫无疑问，对免疫生物标志物的研究和验证可以帮助确定哪些患者从这些药物中获益更多。
