Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA.
Anna-Maria Kellen Clinical Accelerator, Cancer Research Institute, New York, NY, USA.
Lancet Oncol. 2019 Mar;20(3):e175-e186. doi: 10.1016/S1470-2045(19)30026-9.
Immunotherapy is emerging as a new treatment modality in breast cancer. After long-standing use of endocrine therapy and targeted biological therapy, improved understanding of immune evasion by cancer cells and the discovery of selective immune checkpoint inhibitors have created novel opportunities for treatment. Single-drug therapies with monoclonal antibodies against programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) have shown little efficacy in patients with metastatic breast cancer, in part because of the low number of tumour-infiltrating lymphocytes in most breast cancers. There is growing interest in the development of combinations of immunotherapy and molecularly targeted therapies for metastatic breast cancer. In this Personal View, we review the available data and ongoing efforts to establish the safety and efficacy of immunotherapeutic approaches in combination with HER2-targeted therapy, inhibitors of cyclin-dependent kinases 4 and 6, angiogenesis inhibitors, poly(ADP-ribose) polymerase inhibitors, as well as chemotherapy and radiotherapy.
免疫疗法正在成为乳腺癌的一种新的治疗方式。在长期使用内分泌治疗和靶向生物治疗之后,对癌细胞免疫逃逸的深入了解以及选择性免疫检查点抑制剂的发现为治疗创造了新的机会。针对程序性死亡受体 1(PD-1)和程序性死亡配体 1(PD-L1)的单克隆抗体的单药治疗在转移性乳腺癌患者中疗效甚微,部分原因是大多数乳腺癌中肿瘤浸润淋巴细胞的数量较少。人们越来越关注为转移性乳腺癌开发免疫治疗与分子靶向治疗的联合疗法。在这篇个人观点中,我们回顾了现有的数据和正在进行的努力,以确定免疫治疗方法与 HER2 靶向治疗、细胞周期蛋白依赖性激酶 4 和 6 抑制剂、血管生成抑制剂、聚(ADP-核糖)聚合酶抑制剂以及化疗和放疗联合使用的安全性和疗效。
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