Tavares Dione Fernandes, Chaves Ribeiro Victoria, Andrade Marco Antônio Vieira, Moreira Cardoso-Júnior Laércio, Rhangel Gomes Teixeira Thiago, Ramos Varrone Gabriela, Lopes Britto Renata
Graduate program in Medicine and Health, Medicine Faculty of Bahia, Federal University of Bahia, Salvador.
Institute of Chemistry, University of São Paulo, São Paulo.
Oncol Rev. 2021 Dec 6;15(2):497. doi: 10.4081/oncol.2021.497. eCollection 2021 Sep 21.
Breast cancer is the most commonly diagnosed cancer in women and is one of the leading causes of death from cancer in women worldwide. Despite the significant benefits of using conventional chemotherapy in the treatment of breast cancer, one of its subtypes, the triple-negative breast cancer, is still a challenge in clinical practice. Recent studies have been investigating the role of the immune system in breast cancer and the development of immunotherapy. Although recently the use of atezolizumab, an anti-PD-L1 monoclonal antibody, combined with chemotherapy was approved, an important step in the treatment of patients with triple-negative metastatic breast cancer, the use of immunotherapy to treat breast tumors remains a major challenge. In this systematic literature review, following PRISMA guidelines, we searched for clinical trials using immunotherapy in the treatment of metastatic triple-negative breast cancer published until March 2020 in the databases EMBASE, PubMed and Cochrane Central Register of Controlled Trials (CENTRAL), with no language restrictions. We did not contact the authors of the clinical trials to obtain additional information. Two researchers independently collected the data and assessed the quality of this study. The literature shows that immunotherapy with anti-PD-1/PD-L1 agents is emerging as a new treatment option in breast cancer. On the other hand, when compared to other types of cancer in which several agents have already been approved, the research is still in its infancy. The use of anti-PD-1/PD-L1 agents as monotherapy revealed encouraging results in the metastatic setting, especially when administered in the early course of the disease, although combination strategies with chemotherapy appear to increase its efficacy. The main limitation of this study is the approach of cancer only in advanced stages.
乳腺癌是女性中最常被诊断出的癌症，也是全球女性癌症死亡的主要原因之一。尽管传统化疗在乳腺癌治疗中具有显著益处，但其一种亚型——三阴性乳腺癌，在临床实践中仍是一项挑战。最近的研究一直在探究免疫系统在乳腺癌中的作用以及免疫疗法的发展。尽管最近抗程序性死亡受体配体1（PD-L1）单克隆抗体阿特珠单抗与化疗联合使用已获批准，这是三阴性转移性乳腺癌患者治疗中的重要一步，但使用免疫疗法治疗乳腺肿瘤仍然是一项重大挑战。在这项系统文献综述中，我们遵循PRISMA指南，在EMBASE、PubMed和Cochrane对照试验中央注册库（CENTRAL）数据库中搜索截至2020年3月发表的使用免疫疗法治疗转移性三阴性乳腺癌的临床试验，无语言限制。我们未联系临床试验的作者以获取更多信息。两名研究人员独立收集数据并评估本研究的质量。文献表明，使用抗程序性死亡蛋白1（PD-1）/PD-L1药物的免疫疗法正在成为乳腺癌的一种新治疗选择。另一方面，与其他几种药物已获批准的癌症类型相比，该研究仍处于起步阶段。在转移性情况下，使用抗PD-1/PD-L1药物作为单一疗法显示出令人鼓舞的结果，尤其是在疾病早期给药时，尽管与化疗的联合策略似乎能提高其疗效。本研究的主要局限性在于仅针对晚期癌症。
