Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, People's Republic of China.
Department of Pathology, School of Basic Medical Sciences, Wuhan University, Wuhan, 430071, People's Republic of China.
Clin Transl Oncol. 2023 Jun;25(6):1579-1593. doi: 10.1007/s12094-023-03075-y. Epub 2023 Jan 18.
Breast cancer is an epithelial malignant tumor that occurs in the terminal ducts of the breast. Neoadjuvant chemotherapy (NACT) is an important part of breast cancer treatment. Its purpose is to use systemic treatment for some locally advanced breast cancer patients, to decrease the tumor size and clinical stage so that non-operable breast cancer patients can have a chance to access surgical treatment, or patients who are not suitable for breast-conserving surgery can get the opportunity of breast-conserving. However, some patients who do not respond to NACT will lead deterioration in their condition. Therefore, prediction of NACT efficacy in breast cancer is vital for precision therapy. The tumor microenvironment (TME) has a crucial role in the carcinogenesis and therapeutic response of breast cancer. In this review, we summarized the immune cells, immune checkpoints, and other biomarkers in the TME that can evaluate the efficacy of NACT in treating breast cancer. We believe that the detection and evaluation of the TME components in breast cancer are helpful to predict the efficacy of NACT, and the prediction methods are in the prospect. In addition, we also summarized other predictive factors of NACT, such as imaging examination, biochemical markers, and multigene/multiprotein profiling.
乳腺癌是一种发生在乳腺终末导管上皮的恶性肿瘤。新辅助化疗(NACT)是乳腺癌治疗的重要组成部分。其目的是对一些局部晚期乳腺癌患者进行全身性治疗,以缩小肿瘤大小和临床分期,使不能手术的乳腺癌患者有机会接受手术治疗,或使不适合保乳手术的患者有机会接受保乳。然而,一些对 NACT 无反应的患者病情会恶化。因此,预测乳腺癌 NACT 的疗效对于精准治疗至关重要。肿瘤微环境(TME)在乳腺癌的发生和治疗反应中起着关键作用。在这篇综述中,我们总结了 TME 中可以评估 NACT 治疗乳腺癌疗效的免疫细胞、免疫检查点和其他生物标志物。我们认为,检测和评估乳腺癌中的 TME 成分有助于预测 NACT 的疗效,且预测方法具有前瞻性。此外,我们还总结了 NACT 的其他预测因素,如影像学检查、生化标志物和多基因/多蛋白谱。