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Breast cancer immunotherapy: a comprehensive review

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Abstract

Cancer remains a major health problem despite numerous new medical interventions that have been introduced in recent years. One of the major choices for cancer therapy is so-called adoptive cell therapy (ACT). ACT can be performed using both innate immune cells, including dendritic cells (DCs), natural killer (NK) cells, and γδ T cells and acquired immune T cells. It has become possible to utilize these cells in both their native and modified states in clinical studies. Because of considerable success in cancer treatment, ACT now plays a role in advanced therapy protocols. Genetic engineering of autologous and allogeneic immune cells (T lymphocytes, NK cells, macrophages, etc.) with chimeric antigen receptors (CAR) is a powerful new tool to target specific antigens on cancer cells. The Food and Drug Administration (FDA) in the US has approved certain CAR-T cells for hematologic malignancies and it is hoped that their use can be extended to incorporate a variety of cells, in particular NK cells. However, the ACT method has some limitations, such as the risk of rejection in allogeneic engrafts. Accordingly, numerous efforts are being made to eliminate or minimize this and other complications. In the present review, we have developed a guide to breast cancer (BC) therapy from conventional therapy, through to cell-based approaches, in particular novel technologies including CAR with emphasis on NK cells as a new and safer candidate in this field as well as the more recent aptamer technology, which can play a major role in BC immunotherapy.

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Abbreviations

ACT:

Adoptive cell therapy

ADCC:

Antibody-dependent cell-mediated cytotoxicity

AE:

Adverse effect

ApEn-NK:

Aptamer engineered-NK

BC:

Breast cancer

BiKE:

Bi-specific killer engager

BiTE:

Bispecific T-cell engager

CAR:

Chimeric antigen receptor

CEA:

Carcinoembryonic antigen

CIK:

Cytokine-induced killer

CM:

Co-stimulatory molecule

CRS:

Cytokine release syndrome

CSC:

Cancer stem cells

CTL:

Cytotoxic T-lymphocyte

CTLA-4:

Cytotoxic T lymphocyte antigen-4

DC:

Dendritic cell

DCV:

DC-based vaccine

EGFR:

Epidermal growth factor receptor

EpCAM:

Epithelial cell adhesion molecule

FDA:

Food and Drug Administration

GD2:

Disialoganglioside

GvHD:

Graft-versus-host disease

HSPC:

Hematopoietic stem and progenitor cells

HSV:

Herpes simplex virus

HSV-tk:

HSV-1 thymidine kinase

ICIs:

Immune checkpoint inhibitors

IFN:

Interferon

IL:

Interleukin

iNKT:

Invariant natural killer T

iPSC:

Induced pluripotent stem cell

LAK:

Lymphokine-activated killer cells

mAb:

Monoclonal antibody

mBC:

Metastatic breast cancer

MDSC:

Myeloid-derived suppressor cell

MHC:

Major histocompatibility complex

mTOR:

Mammalian target of rapamycin

MUC:

Mucin

NK:

Natural killer

NKT:

Natural killer T

OV:

Oncolytic viruses

PBMC:

Peripheral blood mononuclear cell

PD-1:

Programmed cell death protein 1

pNK:

Primary NK

ROR:

Receptor tyrosine kinase-like orphan receptor

scFv:

Single-chain variable fragment

TAA:

Tumor-associated antigen

TCR-T:

T-cell receptor engineered T

TGF-β:

Transforming growth factor beta

TIL:

Tumor-infiltrating lymphocytes

TME:

Tumor microenvironment

TNBC:

Triple-negative breast cancer

TRUCK:

T cells redirected for universal cytokine killing

T-VEC:

Talimogene laherparepvec

UCB:

Umbilical cord blood

VEGF:

Vascular endothelial growth factor

VV:

Vaccinia virus

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Authors and Affiliations

  1. School of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran

    Samaneh Keshavarz & Somayeh Keshavarz

  2. University of Notre Dame Australia, Sydney, Australia

    Jack R. Wall

  3. Regenerative Medicine, Organ Procurement and Transplantation Multidisciplinary Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Elham Vojoudi

  4. Department of Immunology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Reza Jafari-Shakib

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Writing-original draft preparation, SK; conceptualization, EV and RJ-S; review and editing, RJ-S, EV, and JRW; English language editing, JRW; supervision, EV and RJ-S; and illustration, SK. All authors read the last version of manuscript and approved it for publication.

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Keshavarz, S., Wall, J.R., Keshavarz, S. et al. Breast cancer immunotherapy: a comprehensive review. Clin Exp Med 23, 4431–4447 (2023). https://doi.org/10.1007/s10238-023-01177-z

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