Immunotherapy in Breast Cancer Treatment

The Use of Immunotherapy in Breast Cancer Treatment

Immunotherapy in Breast Cancer Treatment

Introduction

Breast cancer remains the most common type of cancer among females worldwide, and new cases are reported frequently. It has attracted many treatment approaches, and its diverse manifestation has contributed to many approaches to treatment; immunotherapy is among the recent innovations. Immunotherapy signifies the use of the immune system for a targeted cancer cell treatment; it is a more innovative and less toxic treatment as compared to the usual approaches such as chemotherapy and radiation.

Breast Cancer

Breast cancer occurs in the breast without any normal facilitation and is commonly caused by mutations in the genes. Such mutations could be inherited or occur somatically at any point in a woman’s reproductive years. Breast cancer can be grouped into several molecular subtypes according to hormone receptor status, estrogen/progesterone receptors, and HER2 status, among other factors. Knowledge of these molecular features is therefore critical in establishing a treatment intervention plan.

Treatment of Breast Cancer

Conventionally, breast cancer management relied on surgery, radiation, and chemotherapy with the possible addition of hormone therapy or HER2 targets. Although these approaches have enhanced patient’s quality of life, they come with side effects and are not conclusive with patients with advanced or metastatic diseases.

Immunotherapy

Immunotherapy is an advanced technique that strengthens the immune system of the body in order to combat cancer cells. Immunotherapy is different from conventional therapies in that it works to improve the body’s immune system to be able to detect and destroy cancerous cells. This approach has several advantages, such as fewer side effects, non-inflammatory, sustained action, and treatment of primary as well as secondary tumors.

Mechanisms of Immunotherapy

Immune therapy can be classified into subtypes, which are immune checkpoint inhibitors, adoptive cell transfer, cancer vaccines, and oncolytic viruses. All of these concepts aim at cancer cells differently, but all the proposed strategies stimulate the immunologic reaction in the organism to provide a better defense against tumor cells.

1. Immune Checkpoint Inhibitors

Immune checkpoint inhibitors are a category of medications that target proteins in cancer cells or immune cells and eliminate restraint on the immune system from pursuing and eradicating abnormal tissues. Of the two well-established immune checkpoint pathways, the CTLA-4 pathway and the PD-1 pathway are widely known. Immune checkpoint inhibitors derail the cancer proteins, hence allowing for better recognition of the same cells by the immune system.

2. Adoptive Cell Transfer (ACT)

ACT is a procedure in which a patient’s T-cells, a type of white blood cell, are extracted from the body, altered within the laboratory, and then infused back into the patient, with the cells being better armed to fight cancer. The T cells are genetically modified, so they are again inserted back into the patient’s body to identify and kill the cancer cells. Probably the most well-known case of ACT is an instance with a WBC patient diagnosed with metastatic breast cancer who received chimeric antigen receptor (CAR) T cells directed toward HER2-positive cells, subsequently achieving an astonishing pathological response.

3. Cancer Vaccines

Cancer vaccines work intending to release antigens or immune-eliciting agents into the body so that the immune system can easily identify malignant cellular units. These vaccines can be programmed to stimulate an immune response against numerous tumor-associated antigens (TAAs) expressed in breast cancer cells for obliteration of cancer cells with these markers.

4. Oncolytic Viruses

Oncolytic viruses are specially designed viruses that are capable of docking and lysing cancer cells while sparing normal cells. These viruses are known to have the ability to provoke an immune reaction against cancer cells and have been tested both in preclinical and clinical trials for breast cancer.

Immunotherapy in Breast Cancer Treatment
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Recent Progression and Research Studies

There are many active clinical trials regarding the effectiveness of different types of immunotherapy for breast cancer therapy. Some notable examples include:

  1. Immune checkpoint inhibitors: Pembrolizumab and atezolizumab, PD-1 inhibitors, have shown favorable responses in cases of metastatic triple-negative breast cancer as well as hormone receptor-positive, HER2-negative breast cancer. Based on the present study results, further studies can be carried out broadly examining the effectiveness of immune checkpoint inhibitors concerning different breast cancer types.
  2. Bispecific T cell engagers (BiTEs): BiTEs are constructed proteins that selectively and directly target both cancer cells and T cells at the same time and allow the T cell to directly destroy the cancer cell. A still recent Phase I trial of a HER2-targeting BiTE in patients with fourth-line HER2-positive metastatic breast cancer yielded some of the treatments complete responders.
  3. Cancer vaccines: Cancer vaccines are under clinical investigation in several clinical trials based on types of breast cancer and molecular profiles. For instance, a Phase II study of LIPOPEP-Vax belonging to the personalized cancer vaccine indicated similar immune responses and OS in patients diagnosed with early-stage breast cancer.

Limitations and Prospects

However, there are some limitations and issues that hinder immunotherapy for breast cancer treatment even when the clinical trials’ outcomes are promising. Such is the identification of appropriate biomarkers that can be used to gauge the responsiveness of the patient, the establishment of different immunotherapy regimens to improve the effectiveness and reduce side effects, as well as the creation of better and more affordable cancer vaccines.

Moreover, it will be necessary to focus on the possible disadvantages of immunotherapy, for example, the development of immune-related side effects and the emergence of immunotolerance. New solutions will include the use of immunotherapy in conjunction with other targeted therapies or developing immunotherapies with better-targeting profiles that are more suitable for specific patients.

Lastly, immunotherapy has been reported to be a better treatment strategy for breast cancer than conventional treatments since it is less toxic. Immunotherapy will almost certainly continue to feature significantly in additional breast cancer treatment research as the results from clinical trials improve over time. However, a more detailed study of this important concept and collaboration of scientists, practitioners, and manufacturers will be needed to fully explore all the opportunities given by this innovative approach.

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