Department of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Perlmutter Cancer Center, New York University Langone, New York, New York, USA.
J Immunother Cancer. 2021 Aug;9(8). doi: 10.1136/jitc-2021-002597.
Breast cancer has historically been a disease for which immunotherapy was largely unavailable. Recently, the use of immune checkpoint inhibitors (ICIs) in combination with chemotherapy for the treatment of advanced/metastatic triple-negative breast cancer (TNBC) has demonstrated efficacy, including longer progression-free survival and increased overall survival in subsets of patients. Based on clinical benefit in randomized trials, ICIs in combination with chemotherapy for the treatment of some patients with advanced/metastatic TNBC have been approved by the United States (US) Food and Drug Administration (FDA), expanding options for patients. Ongoing questions remain, however, about the optimal chemotherapy backbone for immunotherapy, appropriate biomarker-based selection of patients for treatment, the optimal strategy for immunotherapy treatment in earlier stage disease, and potential use in histological subtypes other than TNBC. To provide guidance to the oncology community on these and other important concerns, the Society for Immunotherapy of Cancer (SITC) convened a multidisciplinary panel of experts to develop a clinical practice guideline (CPG). The expert panel drew upon the published literature as well as their clinical experience to develop recommendations for healthcare professionals on these important aspects of immunotherapeutic treatment for breast cancer, including diagnostic testing, treatment planning, immune-related adverse events (irAEs), and patient quality of life (QOL) considerations. The evidence-based and consensus-based recommendations in this CPG are intended to give guidance to cancer care providers treating patients with breast cancer.
乳腺癌一直是一种免疫疗法基本无效的疾病。最近,免疫检查点抑制剂(ICI)联合化疗治疗晚期/转移性三阴性乳腺癌(TNBC)的疗效已得到证实,包括部分患者的无进展生存期延长和总生存期增加。基于随机试验的临床获益,ICI 联合化疗治疗某些晚期/转移性 TNBC 患者已获得美国(美国)食品和药物管理局(FDA)的批准,为患者提供了更多选择。然而,关于免疫疗法的最佳化疗基础、基于合适生物标志物的患者治疗选择、早期疾病免疫治疗的最佳策略以及在除 TNBC 以外的组织学亚型中的潜在用途等方面仍存在悬而未决的问题。为了就这些和其他重要问题为肿瘤学社区提供指导,癌症免疫治疗学会(SITC)召集了一个多学科专家小组制定临床实践指南(CPG)。专家组参考了已发表的文献和他们的临床经验,就乳腺癌免疫治疗的这些重要方面为医疗保健专业人员制定了建议,包括诊断检测、治疗计划、免疫相关不良事件(irAE)和患者生活质量(QOL)考虑。本 CPG 中的基于证据和共识的建议旨在为治疗乳腺癌患者的癌症护理提供者提供指导。
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