Breast cancer is among the varied diseases, and therefore, it is difficult to contain and treat by doctors and scientists. This is because there are variants of breast cancer disease that are in different ways or ways in which they have variations and also in their response to the treatment. Complicated is triple-negative breast cancer or TNBC, which is also highly invasive. TNBC is different from the standard type of breast cancer since it does not possess the three joint receptors that are typically used in treatment operations.
Immunotherapy is a form of treatment that helps the immune system deal with cancer, and there have been steps up in applying it now. It is revolutionizing the treatment of breast cancer, especially TNBC in particular. Immunotherapy is among the treatment therapies for cancer that assist the body in noticing the cancerous cells and destroying them, making it among the breakthroughs for such patients. With “Immunotherapy Advances: A New Era in Breast Cancer Care,” immunotherapy has been applied to the accurate treatment of breast cancer more and more, which further improves the therapeutic effect of breast cancer and patients’ life quality.
The Promise of Immunotherapy
Immunotherapy is another term for antitumor antibodies that activate the body’s immune system to handle cancer cells. Like all other treatments, including chemotherapy and radiation therapy, which affect the health of normal cells, immunotherapy is unique in that it affects cancer cells and not normal cells. When used for the treatment of specified types of breast cancer, immunotherapy has presented many horizons, thanks to triple-negative breast cancer (TNBC).
TNBC is a more invasive form of breast cancer that does not possess the three common markers that can be found in many other types of breast cancer: estrogen, progesterone, and her2. Due to this, TNBC has fewer receptors, which makes it hard to cure and more prone to spread or recur after treatment has been made. Recent studies show that the TNBC tumor has a significantly higher density of lymphocytes infiltrating the tumor tissue. To that end, better visualization and a higher likelihood of post-immunotherapy treatment results exist within the sight of TILs. TNBC medicines that support a patient’s invulnerable framework can be helpful.
ICIs: Immune Checkpoint Inhibitors
ICIs are new drugs that can be useful to cure breast cancer, particularly the triple-negative breast cancer subtype. These medicines work on specific proteins located on immune cells known as checkpoints, which are naturally designed to halt the immune system from going for cancer cells. If these checkpoints are inhibited, the immune system easily confines and deals with the cancer more efficiently, thus reducing the size of the tumors.
Several researchers state that the utilization of these medicines simultaneously has a positive impact in extending the lives of the patients without making their cancer progress and also extends the patients’ lifespan in general. However, the ICIs are most effective in cancer cells that have a high density of a molecule known as PD-L1. PD-L1 attaches to another protein called PD-1 on the immune cells and suppresses their function. Consequently, assuming that the individual’s cancer cells have elevated degrees of PD-L1, the ICIs will tie all the more proficiently to the PD-L1 and expose it to permit the immune system to go after the cancer.
However, information about ICIs in the early stage of TNBC has also emerged since these drugs are used not only for treating advanced diseases. In studies like KEYNOTE-522 and IMpassing031, which are recent phases of clinical trials, it has been seen that the inclusion of ICIs in a primary neoadjuvant chemotherapy regime results in improved pCR or pathologic complete response, which means that there is no trace of cancer when a patient undergoes surgery. It is also relevant to mention that patients who reach the status of pCR have better long-term survival rates.
Combination Therapies
There are still some new treatments being tried for triple-negative breast cancer to help more people. One of the available types of treatment is immune checkpoint inhibitors or ICIs, which improve the results but do not guarantee success. Clinicians are now exploring ways of increasing the effectiveness of ICIs, and that’s through their application alongside other treatments. For instance, some trials compare ICI with others, especially PARP inhibitors. It is well understood that these drugs enable the repairing of DNA issues that are very common in TNBC.
Other patches attempt to apply ICIs with ADCs, designed to release chemotherapy to cancer cells while leaving healthy cells alone. Besides these combinations, scientists are also researching other immunotherapies. These are cancer vaccines, which assist the body’s defense systems in recognizing and obliterating cancer; adoptive cell therapy, which involves using the patient’s immune cells to eradicate tumors; and oncolytic virus, which may assassinate cancer cells. These different approaches assist patients who have not benefited from using ICIs.
Personalized Immunotherapy
New insights into the management of breast cancer relate to immunological treatment that targets an individual patient. This is based on a more exciting strategy that uses immune cells in the tumor called tumor-infiltrating lymphocytes (TILs).
This is the carefully guarded secret: Specialists first utilize a small part of the patient’s body impacted by disease. They then get the TILs from that piece and let them similarly expand more cells in the laboratory. When the cells divide, they are returned to the patient. Hormones help the immune system differentiate between harmful agents like cancerous cells and react strongly towards the latter.
Researchers have published a study proving this treatment could be beneficial. Three of the six patients with stage four breast cancer also benefited from the TIL treatment; their tumors were reduced in size. This means that if many breast cancer patients undergo this TIL therapy, they will be able to live better lives.
Challenges and Future Directions
It can be seen that the treatment of breast cancer is undergoing positive changes. However, some critical issues should be addressed. There are several concerns, most notably the fact that breast cancer is not necessarily the same from one person to the other. Through this, immunotherapy may work well in treating some types of tumors, while it will not yield any positive results in others. Therefore, to assist doctors in identifying which of their patients will benefit from immunotherapy, researchers are researching to identify unique characteristics known as biomarkers. These markers are PD-L1, TILs, and TMB, the number of tumor mutations.
Immunotherapy has another weakness: side effects. ICIs are usually well-endurable, but in certain instances, they may cause severe autoimmune responses that could be fatal. Researchers are looking for ways to minimize these side effects, and efforts are being made to identify who will likely be affected most. Despite the difficulties previously mentioned, breast cancer immunotherapy still has a lot of potential.
Conclusion
TNBC is a particular class of breast cancer that is unmistakable from different courses. It does not contain specific proteins that other breast cancers have; no particular protein is found in other breast cancers. Hormone therapy, for example, cannot be used to treat TNBC because some treatments are ineffective for this type of cancer. But there’s good news! Scientists have found that this new therapeutic approach is known as immunotherapy for TNBC. Specifically, immunotherapy assists the immune system of the human body to identify cancerous cells and then eliminate them. When radioactive tracers are combined with chemotherapy, patients with TNBC in the advanced stage benefit by extending their life expectancy.
To this end, scientists are putting their best effort into developing better immunotherapy. They want to be sure that they are giving the proper treatment to each patient, depending on their tumor type. This will assist doctors to ensure that they offer their patients the best that they can provide as doctors. Nevertheless, there are a few riding hurdles attached to immunotherapies. At times, it leads to immune responses that are not desirable, and this brings about side effects.
Scientists are also learning how a variety of cells in the same cancer may help or hinder the success of the treatment. But don’t worry! There are many other exciting directions for the application of immunotherapy in breast cancer. There are constant discoveries and innovations in the management and treatment of TNBC so that patients can be relieved and have longer lifespans.