Department of Medicine and Surgery, University of Parma, Str. dell'Università, 12, 43121, Parma, PR, Italy.
Medical Oncology and Breast Unit, University Hospital of Parma, Parma, Italy.
Mol Diagn Ther. 2021 Jul;25(4):409-424. doi: 10.1007/s40291-021-00525-7. Epub 2021 May 11.
Hormone-receptor positive (HR+) breast cancer (BC) (including the luminal A and the luminal B subtypes) is the most common type of tumor in women diagnosed with early-stage BC (EBC). It represents a highly heterogeneous subgroup that is characterized by different risks of relapse. The aim of this review is to discuss the possible role played by the immune response in predicting this risk, along with the most common clinical and pathological factors and molecular tools that have been developed and are already in use. As opposed to what has previously been observed in the most aggressive human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancer (TNBC) subtypes, a high proportion of tumor-infiltrating lymphocytes (TILs)-reflecting a spontaneous and pre-existing immune response to the tumor-has been linked to a worse prognosis in HR+ EBC. This work provides some immune biological rationale explaining these findings and provides the basics to understand the principal clinical trials that are testing immunotherapy in HR+ (luminal) BC.
激素受体阳性(HR+)乳腺癌(BC)(包括 luminal A 和 luminal B 亚型)是女性早期诊断为 BC(EBC)的最常见肿瘤类型。它代表了一个高度异质的亚组,具有不同的复发风险特征。本综述的目的是讨论免疫反应在预测这种风险中的可能作用,以及已经开发并正在使用的最常见的临床和病理因素和分子工具。与之前在最具侵袭性的人类表皮生长因子受体 2(HER2)阳性和三阴性乳腺癌(TNBC)亚型中观察到的情况相反,大量肿瘤浸润淋巴细胞(TILs)——反映了对肿瘤的自发和预先存在的免疫反应——与 HR+ EBC 的预后较差相关。这项工作提供了一些免疫生物学的基本原理来解释这些发现,并为理解正在 HR+(luminal)BC 中测试免疫疗法的主要临床试验提供了基础。