Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC, United States.
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Immunol. 2024 May 13;15:1385484. doi: 10.3389/fimmu.2024.1385484. eCollection 2024.
Breast cancer poses one of the largest threats to women's health. Treatment continues to improve for all the subtypes of breast cancer, but some subtypes, such as triple negative breast cancer, still present a significant treatment challenge. Additionally, metastasis and local recurrence are two prevalent problems in breast cancer treatment. A newer type of therapy, immunotherapy, may offer alternatives to traditional treatments for difficult-to-treat subtypes. Immunotherapy engages the host's immune system to eradicate disease, with the potential to induce long-lasting, durable responses. However, systemic immunotherapy is only approved in a limited number of indications, and it benefits only a minority of patients. Furthermore, immune related toxicities following systemic administration of potent immunomodulators limit dosing and, consequently, efficacy. To address these safety considerations and improve treatment efficacy, interest in local delivery at the site of the tumor has increased. Numerous intratumorally delivered immunotherapeutics have been and are being explored clinically and preclinically, including monoclonal antibodies, cellular therapies, viruses, nucleic acids, cytokines, innate immune agonists, and bacteria. This review summarizes the current and past intratumoral immunotherapy clinical landscape in breast cancer as well as current progress that has been made in preclinical studies, with a focus on delivery parameters and considerations.
乳腺癌是女性健康的最大威胁之一。所有乳腺癌亚型的治疗都在不断改善,但有些亚型,如三阴性乳腺癌,仍然是一个重大的治疗挑战。此外,转移和局部复发是乳腺癌治疗中的两个常见问题。一种新型的治疗方法,免疫疗法,可能为难以治疗的亚型提供传统治疗方法的替代方案。免疫疗法利用宿主的免疫系统来消灭疾病,有可能诱导持久、持久的反应。然而,系统免疫疗法仅在有限数量的适应症中获得批准,并且仅使少数患者受益。此外,在全身给予有效的免疫调节剂后,会出现免疫相关毒性,从而限制了剂量,进而影响疗效。为了解决这些安全问题并提高治疗效果,人们对肿瘤部位的局部给药越来越感兴趣。许多已在临床和临床前探索的瘤内递送免疫疗法包括单克隆抗体、细胞疗法、病毒、核酸、细胞因子、先天免疫激动剂和细菌。本文综述了乳腺癌中当前和过去的瘤内免疫治疗临床现状,以及在临床前研究中取得的进展,重点介绍了给药参数和注意事项。
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