A new treatment has been approved by the FDA to treat breast cancer that combines chemotherapy with immunotherapy.
The war against cancer is ongoing and consists of both winning and losing battles. There are several cancers that have been successfully treated with immunotherapy. However, one type of cancer has been a challenge for the application of immunotherapy is breast cancer. There are various subtypes of breast cancer, and each requires a different treatment approach due to the distinct biology associated with these cancer types and the specific mechanisms involved in breast tumor development.
An important reason for the general lack of adequate response of breast cancers to immunotherapy is a lower expression of PD-L1 (checkpoint proteins used by tumors to overcome immune responses). Also, cells of the immune system are not fully capable of penetrating tumors, limiting the opportunity to be primed to mount an attack against breast tumor cells. Means to activate tumor-infiltrating lymphocytes that can penetrate tumor defenses is one of several areas of investigation that can strengthen the role of immunotherapy in breast cancer treatment.
There is news of hope for the use of immunotherapy for breast cancer. The FDA recently approved a therapy by Roche that combines chemotherapy and the immunotherapy Tecentriq (atezolizumab) for triple-negative breast cancer. This approach controlled the growth of tumors expressing PD-L1 for an average of about 7 months compared to the 5.5 months achieved with chemotherapy alone. Meanwhile, Merck is conducting a Phase 3 clinical trial with the checkpoint inhibitor Keytruda (pembrolizumab) in patients with triple-negative breast cancer.
For now, it appears that a combination therapy approach will provide more promising treatment outcomes due to the complexity of breast tumor growth mechanisms. This can include combining chemotherapy with a number of immunotherapy approaches including the use of checkpoint inhibitors, poly-ADP ribose polymerase (PARP) inhibitors (that block self-repair in cancer cells), and CDK 4/6 inhibitors (affect cell cycle regulation). There is more that needs to be understood regarding how to overcome the hurdles to the successful use of immunotherapy for breast cancer, but the ever-emerging clinical trial data will continue to provide important clues on how to help the immune system fight this complex form of cancer.
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Reference: Xconomy: Immunotherapy Is Now Here For Breast Cancer. What Are Its Prospects?. (2019). Xconomy. Retrieved 25 June 2019, from https://xconomy.com/national/2019/05/29/immunotherapy-is-now-here-for-breast-cancer-what-are-its-prospects/?single_page=true