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Treatment from within: Ductal Carcinoma as an Opportunity to Harness the Immune System

  • Non-Invasive Breast Cancer Diagnosis and Treatment (ES Hwang, Section Editor)
  • Published:
Current Breast Cancer Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Breast Ductal Carcinoma in Situ (DCIS) is an increasingly common diagnosis and already accounts for ~20% of screen-detected breast cancers. A subset of patients with DCIS will experience disease recurrence and some will die from breast cancer. Tailored strategies for treatment are lacking at this time. Human Epidermal Growth Factor Receptor 2 (HER2) is a tumor associated antigen that is shown to correlate with poorer outcomes among patients with early breast cancer, including DCIS. Significant interactions between the humoral and cellular branches of the immune system were observed in tumorigenesis of HER2-expressing lesions. These can be leveraged through administration vaccines to improve outcomes among patients with HER2+ DCIS.

Recent Findings

Pre-clinical and clinical data support that immune response supported not only by CD8+ cytotoxic T cells but also CD4+ helper T cells can lead to antitumor activity in DCIS. These early studies have demonstrated prolonged, broad, activation of the immune system, and with a favorable toxicity profile.

Summary

As nuances in our understanding of immune responses to early breast cancer begin to unveil, there is growing momentum in the development of preventative strategies. Clinical trials assessing the efficacy of vaccines for the treatment of DCIS are forthcoming.

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Funding

Part of the work referenced on this review was supported by U.S. Army Medical Research and Materiel Command (grant number: W81XWH-16-1-0385), Shula Foundation® (www.shulas.com), Pennies in Action® (www.pennies-in-action.org).

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  1. Department of Breast Oncology, H. Lee Moffitt Cancer Center and Research Institute, Moffitt McKinley Outpatient Center, 10920 North McKinley Drive, Tampa, FL, 33612, USA

    Justin G. Wilkes, Brian J. Czerniecki & Ricardo L. B. Costa

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Correspondence to Ricardo L. B. Costa.

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Brian Czerniecki reports intellectual property on DC1 vaccine with ImmunoRestoration. Justin Wilkes declares no conflict of interest relevant to this manuscript. Ricardo Costa received consulting honoraria from Bristol Myers Squibb, Pfizer, Daiichi Sankyo; and recieved research grant from Bristol Meyers Squibb.

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Wilkes, J.G., Czerniecki, B.J. & Costa, R.L.B. Treatment from within: Ductal Carcinoma as an Opportunity to Harness the Immune System. Curr Breast Cancer Rep 12, 82–89 (2020). https://doi.org/10.1007/s12609-020-00356-1

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