Advances in immunotherapy for breast cancer

doi:10.3760/cma.j.cn371439-20231017-00038

Abstract

Abstract:

According to the latest global cancer burden data for 2020 released by the WHO's International Agency for Research on Cancer， breast cancer has become the malignant tumor with the highest incidence worldwide. Based on existing internal medicine treatment means like chemotherapy， targeted therapy and endocrine therapy， the development of immunotherapy provides novel solutions for the treatment of breast cancer. To date， the clinical research of immunotherapy in various molecular types and stages of breast cancer has reached certain achievements. In addition， the exploration of joint application with other therapies， predictive markers for efficacy， and immune-related adverse effects is also ongoing. The research and development in the field of breast cancer immunotherapy holds a promising prospect， and approaching research advances will promote the further application of immunotherapy in breast cancer.

Key words: Breast neoplasms, Immunotherapy, Immune checkpoint inhibitors, Neoadjuvant therapy

Sa Qiang, Xu Hangcheng, Wang Jiayu. Advances in immunotherapy for breast cancer[J]. Journal of International Oncology, 2024, 51(4): 227-234.

Figures/Tables 1

研究类别	期别	研究名称	研究对象（例数）	方案	结果	补充说明
HR阳性乳腺癌免疫治疗	Ⅱ	GIADA^[10]	HR阳性/HER2阴性乳腺癌（n=43）	3周期表柔比星+环磷酰胺，8周期依西美坦+纳武利尤单抗	pCR率：16.3%
	Ⅱ	I-SPY2^[11]	HR阳性/HER2阴性乳腺癌（n=136）	帕博利珠单抗（n=40）比紫杉醇标准化疗（n=96）	pCR率：30%比13%
	Ⅲ	KEYNOTE-756^[12] （NCT03725059）	ER阳性/HER2阴性乳腺癌	帕博利珠单抗+新辅助化疗+辅助内分泌治疗	进行中
	Ⅲ	CheckMate 7FL^[13] （NCT04109066）	ER阳性/HER2阴性乳腺癌	纳武利尤单抗+新辅助化疗+辅助内分泌治疗	进行中
双ICI联合治疗转移性乳腺癌	Ⅱ	Nimbus^[14]	高肿瘤突变负荷的HER2阴性转移性乳腺癌（n=30）	纳武利尤单抗+伊匹木单抗	ORR：13.3%
双ICI联合治疗转移性乳腺癌	Ⅱ	DART^[15]	HER2阴性转移性乳腺癌（n=17）	纳武利尤单抗+伊匹木单抗	中位PFS：2个月，ORR：18%，中位OS：12个月	包含TNBC 13例、ER/PR低表达+HER2阴性3例、ER/PR阳性+HER2 阴性1例
PARP抑制剂联合ICI治疗乳腺癌	Ⅰb/Ⅱ	TOPACIO/KEYNOTE-162^[16]	晚期或转移性TNBC（n=55，其中47例可评估疗效）	尼拉帕利+帕博利珠单抗	ORR：21%，DCR：49%，中位PFS：BRCA突变者8.3个月、BRCA野生型2.1个月
	Ⅰ/Ⅱ	MEDIOLA^[17]	种系BRCA突变的实体肿瘤（包含34例乳腺癌）	奥拉帕利+度伐利尤单抗	HR阳性亚组（n=13）对比TNBC亚组（n=17），中位PFS：9.9个月比4.9个月，ORR：69%比59%，中位OS：22.4个月比20.5个月	与OlympiAD研究中奥拉帕利单药治疗的PFS与缓解率相近^[18]
	Ⅱ	NCT02849496^[19]	非HER2阳性乳腺癌	奥拉帕利+阿替利珠单抗	进行中
	Ⅱ/Ⅲ	KEYLYNK-009（NCT04191135）^[20]	TNBC	奥拉帕利比化疗+帕博利珠单抗	进行中
TKI联合ICI治疗转移性TNBC	Ⅱ	COLET^[21]	转移性TNBC（n=106）	考比替尼+紫杉醇、考比替尼+阿替利珠单抗+紫杉醇、考比替尼+阿替利珠单抗+白蛋白紫杉醇	ORR：38.3%比34.4%比29.0%	阿替利珠单抗队列中，PD-L1阳性者的中位PFS与ORR存在改善趋势
TKI联合ICI治疗转移性TNBC	Ⅱ	LEAP-005^[22]	既往接受过1~2线治疗后进展的转移性TNBC（n=31）	仑伐替尼+帕博利珠单抗	ORR：29%

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