Immuntherapie bei Brustkrebs

Zusammenfassung

Während bei anderen soliden Tumoren Immuntherapie seit Jahren zum Therapiestandard gehört, steht sie bei Brustkrebs noch ganz am Anfang. Klinisch relevant ist sie beim triple-negativen Mammakarzinom (TNBC). Seit 2019 ist der PD-L1-Inhibitor (PD-L1: Programmed death-ligand 1) Atezolizumab als Erstlinientherapie beim metastasierten TNBC zugelassen. Vielversprechende Daten gibt es auch zur neoadjuvanten Therapie bei TNBC sowohl für Atezolizumab als auch für den PD1-Inhibitor Pembrolizumab. Studien beim luminalen frühen Mammakarzinom laufen derzeit. Eine kommentierte Übersicht.

Publication History

Article published online:
23 March 2022

• Literatur

• 1 Marra A, Trapani D, Viale G. et al. Practical classification of triple-negative breast cancer: intratumoral heterogeneity, mechanisms of drug resistance, and novel therapies. NPJ Breast Cancer 2020; 6: 54
• 2 Schmid P, Adams S, Rugo HS. et al. IMpassion130 Trial Investigators. Atezolizumab and Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer. N Engl J Med 2018; 379: 2108-2121
• 3 Schmid P, Rugo HS, Adams S. et al. IMpassion130 Investigators. Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2020; 21: 44-59
• 4 Rugo HS, Loi S, Adams S. et al. Performance of PD-L1 immunohistochemistry (IHC) assays in unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC): Posthoc analysis of IMpassion130. Ann Oncol 2019; 30: v851-v934
• 5 Miles DW, Gligorov J, André F. et al. Primary results from IMpassion131, a double-blind placebo-controlled randomised phase III trial of first-line paclitaxel (PAC)±atezolizumab (atezo) for unresectable locally advanced/metastatic triple-negative breast cancer (mTNBC). Ann Oncol 2020; 31: S1142-S1215
• 6 Cortes J, Cescon DW, Rugo HS. et al. KEYNOTE-355 Investigators. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. Lancet 2020; 396: 1817-1828
• 7 Cortés J, Lipatov O, Im S. et al. KEYNOTE-119: Phase 3 study of pembrolizumab (pembro) versus single-agent chemotherapy (chemo) for metastatic triple-negative breast cancer (mTNBC). Ann Oncol 2019; 30: v851-v934
• 8 Schmid P, Cortes J, Pusztai L. et al. KEYNOTE-522 Investigators. Pembrolizumab for early triple negative breast cancer. N Engl J Med 2020; 382: 810-821
• 9 Mittendorf EA, Zhang H, Barrios CH. et al. Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial. Lancet 2020; 396: 1090-1100
• 10 Gianni L, Huang C, Egle D. et al. Pathologic complete response to neoadjuvant treatment with or without atezolizumab in triple-negative, early high-risk and locally advanced breast cancer. NeoTRIPaPDL1 Michelangelo randomized study. San Antonio Breast Cancer Symposium. 2019 Abstr. GS3-04
• 11 Bianchini G, Huang C, Egle D. et al. Tumour infiltrating lymphocytes (TILs), PD-L1 expression and their dynamics in the NeoTRIPaPDL1 trial. Ann Oncol 2020; 31: S1142-S1215
• 12 Gluz O, Nitz U, Liedtke C. et al. Comparison of neoadjuvant Nab-Paclitaxel+Carboplatin vs. Nab-Paclitaxel+Gemcitabine in triple-negative breast cancer: Randomized WSGADAPT-TN Trial Results. J Natl Cancer Inst 2018; 110: 628-637
• 13 AGO Kommission Mamma. Diagnostik und Therapie früher und fortgeschrittener Mammakarzinome. Version 2020.1. Online (Stand: 01.12.2020): http://www.agoonline.de