Sriramulu Sushmitha, Thoidingjam Shivani, Speers Corey, Nyati Shyam
Department of Radiation Oncology, Henry Ford Cancer Institute, Henry Ford Health, Detroit, MI 48202, USA.
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA.
Cancers (Basel). 2024 Sep 24;16(19):3250. doi: 10.3390/cancers16193250.
Triple-negative breast cancer (TNBC) lacks the expression of estrogen receptors (ERs), human epidermal growth factor receptor 2 (HER2), and progesterone receptors (PRs). TNBC has the poorest prognosis among breast cancer subtypes and is more likely to respond to immunotherapy due to its higher expression of PD-L1 and a greater percentage of tumor-infiltrating lymphocytes. Immunotherapy has revolutionized TNBC treatment, especially with the FDA's approval of pembrolizumab (Keytruda) combined with chemotherapy for advanced cases, opening new avenues for treating this deadly disease. Although immunotherapy can significantly improve patient outcomes in a subset of patients, achieving the desired response rate for all remains an unmet clinical goal. Strategies that enhance responses to immune checkpoint blockade, including combining immunotherapy with chemotherapy, molecularly targeted therapy, or radiotherapy, may improve response rates and clinical outcomes. In this review, we provide a short background on TNBC and immunotherapy and explore the different types of immunotherapy strategies that are currently being evaluated in TNBC. Additionally, we review why combination strategies may be beneficial, provide an overview of the combination strategies, and discuss the novel immunotherapeutic opportunities that may be approved in the near future for TNBC.
三阴性乳腺癌(TNBC)缺乏雌激素受体(ERs)、人表皮生长因子受体2(HER2)和孕激素受体(PRs)的表达。TNBC在乳腺癌亚型中预后最差,由于其PD-L1表达较高且肿瘤浸润淋巴细胞比例较大,更有可能对免疫疗法产生反应。免疫疗法彻底改变了TNBC的治疗方式,尤其是随着美国食品药品监督管理局(FDA)批准帕博利珠单抗(可瑞达)联合化疗用于晚期病例,为治疗这种致命疾病开辟了新途径。尽管免疫疗法可以显著改善一部分患者的治疗效果,但实现对所有患者的理想缓解率仍然是一个未满足的临床目标。增强对免疫检查点阻断反应的策略,包括将免疫疗法与化疗、分子靶向疗法或放疗相结合,可能会提高缓解率和临床疗效。在本综述中,我们提供了TNBC和免疫疗法的简短背景知识,并探讨了目前正在TNBC中评估的不同类型的免疫疗法策略。此外,我们回顾了联合策略为何可能有益,概述了联合策略,并讨论了可能在不久的将来被批准用于TNBC的新型免疫治疗机会。
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