Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond
Is breast cancer (BC) immunogenic? Many data suggest that it is. Many observations demonstrated the prognostic role of tumor-infiltrating lymphocytes (TILs) in triple negative (TN) and human epidermal growth factor receptor 2 (HER-2)-positive BC. TNBCs are poorly differentiated tumors with high gene...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2016-09-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/1758834016658423 |
| _version_ | 1818478485167931392 |
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| author | Cristina Migali Monica Milano Dario Trapani Carmen Criscitiello Angela Esposito Marzia Locatelli Ida Minchella Giuseppe Curigliano |
| author_facet | Cristina Migali Monica Milano Dario Trapani Carmen Criscitiello Angela Esposito Marzia Locatelli Ida Minchella Giuseppe Curigliano |
| author_sort | Cristina Migali |
| collection | DOAJ |
| description | Is breast cancer (BC) immunogenic? Many data suggest that it is. Many observations demonstrated the prognostic role of tumor-infiltrating lymphocytes (TILs) in triple negative (TN) and human epidermal growth factor receptor 2 (HER-2)-positive BC. TNBCs are poorly differentiated tumors with high genetic instability and very high heterogeneity. This heterogeneity enhances the ‘danger signals’ and select clone variants that could be more antigenic or, in other words, that could more strongly stimulate a host immune antitumor response. The response to chemotherapy is at least partly dependent on an immunological reaction against those tumor cells that are dying during the chemotherapy. One of the mechanisms whereby chemotherapy can stimulate the immune system to recognize and destroy malignant cells is commonly known as immunogenic cell death (ICD). ICD elicits an adaptive immune response. Which are the clinical implications of all ‘immunome’ data produced in the last years? First, validate prognostic or predictive role of TILs. Second, validate immune genomic signatures that may be predictive and prognostic in patients with TN disease. Third, incorporate an ‘immunoscore’ into traditional classification of BC, thus providing an essential prognostic and potentially predictive tool in the pathology report. Fourth, implement clinical trials for BC in the metastatic setting with drugs that target immune-cell–intrinsic checkpoints. Blockade of one of these checkpoints, cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) or the programmed cell death 1 (PD-1) receptor may provide proof of concepts for the activity of an immune-modulation approach in the treatment of a BC. |
| first_indexed | 2024-12-10T09:48:55Z |
| format | Article |
| id | doaj.art-b63950ae488c4cb184d3e41f210b3f07 |
| institution | Directory Open Access Journal |
| issn | 1758-8340 1758-8359 |
| language | English |
| last_indexed | 2024-12-10T09:48:55Z |
| publishDate | 2016-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-b63950ae488c4cb184d3e41f210b3f072022-12-22T01:53:43ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83401758-83592016-09-01810.1177/1758834016658423Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyondCristina MigaliMonica MilanoDario TrapaniCarmen CriscitielloAngela EspositoMarzia LocatelliIda MinchellaGiuseppe CuriglianoIs breast cancer (BC) immunogenic? Many data suggest that it is. Many observations demonstrated the prognostic role of tumor-infiltrating lymphocytes (TILs) in triple negative (TN) and human epidermal growth factor receptor 2 (HER-2)-positive BC. TNBCs are poorly differentiated tumors with high genetic instability and very high heterogeneity. This heterogeneity enhances the ‘danger signals’ and select clone variants that could be more antigenic or, in other words, that could more strongly stimulate a host immune antitumor response. The response to chemotherapy is at least partly dependent on an immunological reaction against those tumor cells that are dying during the chemotherapy. One of the mechanisms whereby chemotherapy can stimulate the immune system to recognize and destroy malignant cells is commonly known as immunogenic cell death (ICD). ICD elicits an adaptive immune response. Which are the clinical implications of all ‘immunome’ data produced in the last years? First, validate prognostic or predictive role of TILs. Second, validate immune genomic signatures that may be predictive and prognostic in patients with TN disease. Third, incorporate an ‘immunoscore’ into traditional classification of BC, thus providing an essential prognostic and potentially predictive tool in the pathology report. Fourth, implement clinical trials for BC in the metastatic setting with drugs that target immune-cell–intrinsic checkpoints. Blockade of one of these checkpoints, cytotoxic T-lymphocyte-associated antigen-4 (CTLA-4) or the programmed cell death 1 (PD-1) receptor may provide proof of concepts for the activity of an immune-modulation approach in the treatment of a BC.https://doi.org/10.1177/1758834016658423 |
| spellingShingle | Cristina Migali Monica Milano Dario Trapani Carmen Criscitiello Angela Esposito Marzia Locatelli Ida Minchella Giuseppe Curigliano Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond Therapeutic Advances in Medical Oncology |
| title | Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond |
| title_full | Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond |
| title_fullStr | Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond |
| title_full_unstemmed | Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond |
| title_short | Strategies to modulate the immune system in breast cancer: checkpoint inhibitors and beyond |
| title_sort | strategies to modulate the immune system in breast cancer checkpoint inhibitors and beyond |
| url | https://doi.org/10.1177/1758834016658423 |
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