Treating breast cancer with cell-based approaches: an overview

ABSTRACT

Introduction: Breast cancer is the most common malignancy in women. Despite there being considerable progress in the treatment of this disease, metastatic dissemination is still considered an incurable condition at the present time, causing 500,000 deaths worldwide every year. Although most of the research efforts have been focused on pharmacological approaches, over the last three decades, the use of bone marrow and peripheral blood-derived cell therapy approaches have been attempted and developed.

Areas covered: This review will briefly address cell therapy for breast cancer, including autologous stem cell transplantations for overcoming the myelosuppressive effects of high-dose chemotherapy, allogeneic stem cell transplants and adoptive immunotherapy using bone-marrow derived T-cells.

Expert opinion: The treatment of breast cancer using bone marrow or peripheral-blood derived cells has evolved from a supportive care approach to allow dose escalation of conventional chemotherapy to a therapeutic strategy aimed at eliciting immune cell mediated anticancer immunity. This latter principle has led to the development of adoptive immunotherapies, either with ‘natural’ or genetically engineered effectors, which are being intensively investigated for their great potential against several solid tumors, including breast cancer.

KEYWORDS:

• Breast cancer
• cancer metastasis
• high-dose chemotherapy
• bone marrow transplant
• peripheral blood stem cell transplant
• allogeneic transplant
• adoptive cell immunotherapy

Article highlights

• Despite notable progress in the treatment of breast cancer, when it recurs with metastatic spread it still remains an incurable disease

• Parallel to newer pharmacological strategies, treating breast cancer with bone marrow or peripheral-blood derived cells has been pursued for the last three decades

• Using hematopoietic stem cells to rescue patients after myeloablative doses of conventional chemotherapy failed to show efficacy and yielded increased toxicity

• Allogeneic hematopoietic transplant showed that a graft versus tumor effect could result in therapeutic efficacy in solid tumors, including breast cancer

• Newer cell therapy approaches using immune effectors with intrinsic or conferred antitumor activity are a promising area of investigation in solid tumors, including breast cancer

• Logistic and regulatory issues are a challenge that needs to be overcome to allow a systematic evaluation of newer cell therapy approaches in breast cancer

Declaration of interest

F Montemurro has received speaker’s honoraria from Novartis, Roche and AstraZeneca. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

The authors are supported by the Fondazione Piemontese per la Ricerca sul Cancro (FPRC) (onlus) 5 per 1000 funds from the Ministero della Salute (2012).