三阴性乳腺癌的免疫治疗研究进展

Advances in immunotherapy for triple-negative breast cancer

关键词:  三阴性乳腺癌  免疫治疗  癌症疫苗  免疫检查点

Key words:  triple-negative breast cancer  immunotherapy  cancer vaccine  immune checkpoint

摘要:

三阴性乳腺癌因受体雌激素受体（ER）、孕激素受体（PR）及人表皮生长因子受体2（HER2）均阴性，缺乏内分泌及抗HER2治疗的靶点，目前仍以手术、化疗和放疗为主，相对于这些常规的治疗方案，乳腺癌免疫治疗等新型治疗方式也相对滞后。三阴性乳腺癌免疫治疗的策略包括增强树突状细胞抗原递呈能力和活化效应T细胞功能，抑制调节性T细胞和髓源性抑制细胞，以及上调相关细胞因子，逆转肿瘤抑制性微环境，促进抗肿瘤免疫反应，从而发挥杀伤肿瘤细胞的功能。在实体肿瘤中程序性死亡受体1（PD-1）/其配体PD-L1的抗体治疗取得了可喜的成绩，并在三阴性乳腺癌患者中做了小样本的临床试验，三阴性乳腺癌的免疫治疗越来越引人关注，中医药在三阴性乳腺癌也做了很多尝试。文章对三阴性乳腺癌免疫治疗的现状和展望作综述。

Abstract:

Triple-negative breast cancer lacks endocrine and anti-human epidermal growth factor receptor 2 (HER2) therapeutic targets because its receptor estrogen receptor (ER),progesterone receptor (PR) and HER2 are all negative. At present,surgery,chemotherapy and radiotherapy are still the main treatments. Compared with these conventional treatment schemes,new treatment methods such as breast cancer immunotherapy are also lagging behind. The strategies of immunotherapy for triple-negative breast cancer include enhancing the antigen presenting ability of dendritic cells and activating the function of effector T cells,inhibiting regulatory T cells and myelogenous suppressor cells,and up-regulating related cytokines,reversing tumor inhibitory microenvironment and promoting anti-tumor immune response. Thereby exerting the function of killing tumor cells. The antibody therapy of programmed death receptor 1 (PD-1)/its ligand PD-L1 in solid tumors has made gratifying achievements,and a small sample of clinical trials have been done in patients with triple-negative breast cancer. The immunotherapy of triple-negative breast cancer has attracted more and more attention,and Chinese medicine has also made many attempts in triple-negative breast cancer. This paper summarizes the present situation and prospect of immunotherapy of triple-negative breast cancer.