The Influence of Host Factors on the Prognosis of Breast Cancer: Stroma and Immune Cell Components as Cancer Biomarkers
The Influence of Host Factors on the Prognosis of Breast Cancer: Stroma and Immune Cell Components as Cancer Biomarkers
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DOI：
10.2174/156800961508151001101209
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发表时间：
2015-01-01
影响因子：
3
通讯作者：
Becker, Sven
中科院分区：
文献类型：
--
作者：
Karn, Thomas;Pusztai, Lajos;Becker, Sven
本文就乳腺癌微环境中间质成分和免疫学参数作为乳腺癌预后和预测标记物的研究进展作一综述。由于最近免疫治疗方面的突破，宿主对癌症的免疫反应变得越来越重要。目前，乳腺癌的分子和临床亚型仅仅基于癌细胞的分子特征，而没有考虑间质成分的重要性。现在有明确的证据表明，浸润性免疫细胞和炎性细胞影响乳腺癌的生物学和临床过程。然而，免疫细胞的预后和预测功能在不同的乳腺癌亚型中有所不同。免疫参数在三阴性和HER2阳性乳腺癌中建立和验证了预后和预测标记，并可准备用作临床试验的分层参数和临床决策时的辅助变量。另一方面，在低级别、管腔A型乳腺癌中，预后和预测的影响微乎其微。在TNBC和HER2阳性癌症中，较高的淋巴细胞浸润率与较好的预后(包括更高的化疗敏感性)之间的强烈关联也提出了以免疫细胞为靶点以提高其活性的新的治疗选择。免疫标记物也有可能作为预测标记物来选择免疫治疗方案的患者(例如检查点抑制剂)。
In this paper, we will review the data on stromal components and immunological parameters in the cancer microenvironment as prognostic and predictive markers in breast cancer. Host immunological response to cancer has gained importance because of recent breakthroughs in immunotherapy. Currently, molecular and clinical subtyping of breast cancer is solely based on the molecular features of the cancer cells without considering the importance of stromal components. There is now clear evidence that infiltrating immune and inflammatory cells influence the biology and clinical course of breast cancer. However, the prognostic and predictive function of immune cells differs between breast cancer subtypes. Immune parameters are established and validated prognostic and predictive markers in triple negative and for HER2 positive breast cancers and may be ready to be used as stratification parameters in clinical trials and as adjunct variables when making clinical decisions. On the other hand, the prognostic and predictive impact is minimal in low grade, luminal A type breast cancers. The strong association between higher lymphocytic infiltration and better outcome (including greater chemotherapy sensitivity) in TNBC and HER2 positive cancers also raises novel therapeutic options that target immune cells to increase their activity. Immune markers also carry the potential to serve as predictive markers to select patients for immunotherapeutic regimens (e.g. checkpoint inhibitors).