癌症中的免疫检查点抑制剂：机制、生物标志物和未来的治疗策略

摘要(中文译文)

免疫检查点抑制剂（ICI）的出现从根本上改变了乳腺癌治疗的格局，代表着从传统细胞毒性方法向精准免疫治疗的范式转变。这篇综合性综述审视了ICI在乳腺癌中的现状和未来方向，特别强调了三阴性乳腺癌（TNBC），因为这些疗法在该领域显示出最大的前景。我们探讨了靶向CTLA-4、PD-1和PD-L1通路的检查点抑制的机制基础，审视了耐药机制和预测性生物标志物，并讨论了包括LAG-3、TIM-3和TIGIT在内的新兴靶点。ICI与传统疗法的整合已产生令人鼓舞的临床结果，促成了FDA首次批准免疫疗法用于乳腺癌。然而，在识别最佳患者人群、克服耐药机制和开发稳健的预测性生物标志物方面仍存在重大挑战。本综述综合了近期临床试验的当前证据，并对有望增强免疫检查点阻断在乳腺癌治疗中疗效的未来治疗策略提供了见解。

Abstract

The landscape of breast cancer treatment has been fundamentally transformed by the emergence of immune checkpoint inhibitors (ICIs), representing a paradigm shift from traditional cytotoxic approaches to precision immunotherapy. This comprehensive review examines the current state and future directions of ICIs in breast cancer, with particular emphasis on triple-negative breast cancer (TNBC) where these therapies have shown the most promise. We explore the mechanistic foundations of checkpoint inhibition targeting CTLA-4, PD-1, and PD-L1 pathways, examine resistance mechanisms and predictive biomarkers, and discuss emerging targets including LAG-3, TIM-3, and TIGIT. The integration of ICIs with conventional therapies has yielded encouraging clinical outcomes, leading to the first FDA approvals for immunotherapy in breast cancer. However, significant challenges remain in identifying optimal patient populations, overcoming resistance mechanisms, and developing robust predictive biomarkers. This review synthesizes current evidence from recent clinical trials and provides insights into future therapeutic strategies that promise to enhance the efficacy of immune checkpoint blockade in breast cancer treatment.

如何引用

Therapeutics and clinical risk management 的其他文献

• Camrelizumab联合阿帕替尼治疗晚期不可切除肺泡软组织肉瘤和未分化多形性肉瘤患者：单中心探索性病例系列
• 人工智能在肺结核诊断和管理中的应用：当前应用和未来前景综述
• 预防子宫腺肌病LNG-IUS排斥的叙述性综述和风险分层框架