Breast cancer and immunology: biomarker and therapeutic developments

Abstract

While breast cancer has not historically been considered an immunogenic cancer, recent data demonstrating the powerful anti-cancer effects of immune checkpoints in many cancers, including breast cancer, has reinvigorated the field. Although the responses are generally low with single agents, some patients experience disease control for a long period of time. Selecting appropriate patients for immunotherapy is an important area of research, and many biomarkers are under investigation. Although immunotherapies are still in their early stages of development, learning how to use them in combination with other agents that can alter antigen presentation or other immune elements will be crucial. This review aims to summarize efforts in immune-related biomarker and drug development, particularly as it pertains to breast cancer.

Keywords:

• biomarkers
• breast cancer
• checkpoint inhibitors
• drug development
• immunotherapy

Financial & competing interests disclosure

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Immune system surveillance can eliminate abnormal cells including cancer cells, a premise that has been tested for the treatment of cancer.

• Historically, breast cancer has not been thought to be an immunogenic cancer as have other cancers such as melanoma, but recent studies using checkpoint inhibitors have demonstrated significant clinical efficacy in breast cancers.

• While cancer vaccines have not proven efficacious in breast cancer, newer studies combining them with adjuvants and immunomodulators offer promising results.

• As our understanding of how immunotherapies work increases, developing biologically rationale combinations may ultimately translate into improved patient outcomes.

• Biomarker development may help identify those most likely to benefit from these therapies, but may also shed light into the biology of immunotherapies and how to improve on them.

Notes