Immunotherapy in Breast Cancer

Immunotherapy in Breast Cancer

9 July 2024 | Kathrin Dvir, Sara Giordano, Jose Pablo Leone
The article reviews the current landscape of immunotherapy in breast cancer, focusing on the use of checkpoint inhibitors (ICIs) and their impact on different subtypes of breast cancer. Breast cancer, a spectrum of molecular subtypes, has traditionally been considered an immunologically "cold" tumor, but recent clinical trials have shown that immunotherapy can be an effective therapeutic option for select patients. The review highlights the need for tailored treatment strategies due to the diverse nature of breast cancer subtypes, including HR+, HER2-negative, HER2-positive, and triple-negative breast cancer (TNBC). Despite advancements in early detection and new therapeutic modalities, breast cancer remains a leading cause of cancer death, especially in younger women. Immunotherapy, particularly ICIs, has emerged as a promising treatment approach, with pembrolizumab approved for combination with chemotherapy in TNBC. The review discusses the mechanisms of action of ICIs, their combination with chemotherapy, and the role of biomarkers such as PD-L1 expression, Tumor Mutation Burden (TMB), and Tumor-Infiltrating Lymphocytes (TILs) in predicting response and guiding treatment decisions. It also explores ongoing and future research directions, including the integration of ICIs with antibody-drug conjugates (ADCs) and the development of novel immunotherapeutic agents like CAR-T cells and oncolytic viruses. The article emphasizes the importance of biomarker identification, real-world data, and long-term follow-up to optimize patient selection and improve outcomes in breast cancer treatment.The article reviews the current landscape of immunotherapy in breast cancer, focusing on the use of checkpoint inhibitors (ICIs) and their impact on different subtypes of breast cancer. Breast cancer, a spectrum of molecular subtypes, has traditionally been considered an immunologically "cold" tumor, but recent clinical trials have shown that immunotherapy can be an effective therapeutic option for select patients. The review highlights the need for tailored treatment strategies due to the diverse nature of breast cancer subtypes, including HR+, HER2-negative, HER2-positive, and triple-negative breast cancer (TNBC). Despite advancements in early detection and new therapeutic modalities, breast cancer remains a leading cause of cancer death, especially in younger women. Immunotherapy, particularly ICIs, has emerged as a promising treatment approach, with pembrolizumab approved for combination with chemotherapy in TNBC. The review discusses the mechanisms of action of ICIs, their combination with chemotherapy, and the role of biomarkers such as PD-L1 expression, Tumor Mutation Burden (TMB), and Tumor-Infiltrating Lymphocytes (TILs) in predicting response and guiding treatment decisions. It also explores ongoing and future research directions, including the integration of ICIs with antibody-drug conjugates (ADCs) and the development of novel immunotherapeutic agents like CAR-T cells and oncolytic viruses. The article emphasizes the importance of biomarker identification, real-world data, and long-term follow-up to optimize patient selection and improve outcomes in breast cancer treatment.
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