The 3rd Immuno-Oncology

World Congress

Breast cancer is a heterogeneous disease, including a wide range of pathological and clinical behaviors. Current treatment protocols, including radiotherapy, chemotherapy, and hormone replacement therapy, can cure most of patients, but, particularly in some subgroups like the triple negative or metastatic ones, effectiveness is not enough to impact on survival and more efforts are needed to develop alternative options.

Immunotherapy, as a novel strategy addressing the immune system, has demonstrated a strong potential in treating those highly mutated and immunogenic cancers.

Although breast cancer has long been considered a problematic target for immunotherapy, as it is immunologically “cold,” numerous recent preclinical and clinical reports now recommend that immunotherapy alone or in combination with chemotherapy, can be used to treat specific subsets of breast cancer patients.

Various strategies include not only immune-checkpoint inhibition with antiPD1s/PDL1s, but also vaccination and adoptive T-cell therapy (CAR-T).

Pembrolizumab, an anti-PD-1 human mAb, was tested in advanced triple negative patients. Expression of PD1 was detected in 60% of patients and efficacy in 27 cases: the overall response was 18.5%, with 1 complete remission reached. Atezolizumab, a human anti-PDL1, was tested with paclitaxel in 32 patients showing anti-tumor efficacy in 70% of TNBC patients. Avelumab, has been evaluated in a phase 2 clinical trial showing responses in 40 out of 168 patients (23.8%).

Several vaccine approaches, comprising of monovalent, polyvalent, and cellular vaccines, have been assessed, but results are not satisfactory due to the difficulties in identifying a set of tumor associated antigens able to personalize the treatment.

Adoptive T-cell transfer therapy is still on the run, mainly targeting HER2 positive tumors and new approaches using CAR-T seem effective and safe, meriting further development in clinical trials.