Matusz-Fisher Ashley, Tan Antoinette R
Hematology/Oncology Fellow, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.
Chief of Breast Medical Oncology, Co-Director, Phase I Program, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA.
Expert Opin Biol Ther. 2022 Mar;22(3):385-395. doi: 10.1080/14712598.2021.1981284. Epub 2021 Nov 21.
Human epidermal growth factor receptor 2 (HER2)-positive breast cancers account for approximately 15 to 20% of breast cancer diagnoses. Historically, HER2-positive breast cancers had been associated with poorer prognosis. The addition of HER2-targeted agents to treatment regimens has significantly improved outcomes for patients with HER2-positive breast cancer. Despite this, relapses continue to occur in about 20% of patients. Newer therapeutic strategies are needed. The role of immunotherapy in the treatment of HER2-positive breast cancer is currently under clinical investigation.
This article will focus on the clinical trial data evaluating immune checkpoint inhibitors, including pembrolizumab, atezolizumab, avelumab, durvalumab, and nivolumab in the treatment of HER2-positive breast cancer.
The incorporation of immunotherapy in the treatment of HER2-positive breast cancer is a reasonable strategy. Clinical trials of checkpoint inhibitors with HER2-targeted agents show clinical activity in HER2-positive breast cancer tumors that are programmed cell death-ligand 1 (PD-L1) positive and also when used as an earlier line of therapy in the metastatic setting. Treatment of HER2-positive breast cancer with immunotherapy and HER2-targeted agents warrants continued clinical investigation.
人表皮生长因子受体2（HER2）阳性乳腺癌约占乳腺癌诊断病例的15%至20%。从历史上看，HER2阳性乳腺癌的预后较差。在治疗方案中添加HER2靶向药物显著改善了HER2阳性乳腺癌患者的治疗结果。尽管如此，仍有大约20%的患者会复发。需要更新的治疗策略。免疫疗法在HER2阳性乳腺癌治疗中的作用目前正在临床研究中。
本文将重点关注评估免疫检查点抑制剂（包括帕博利珠单抗、阿特珠单抗、阿维鲁单抗、度伐鲁单抗和纳武利尤单抗）治疗HER2阳性乳腺癌的临床试验数据。
将免疫疗法纳入HER2阳性乳腺癌的治疗是一种合理的策略。检查点抑制剂与HER2靶向药物的临床试验显示，在程序性细胞死亡配体1（PD-L1）阳性的HER2阳性乳腺癌肿瘤中以及在转移性环境中作为早期治疗方案使用时均具有临床活性。用免疫疗法和HER2靶向药物治疗HER2阳性乳腺癌值得继续进行临床研究。
