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Immunothérapie et cancer du sein

Immunotherapy and breast cancer

  • Revue de la Littérature / Literature Review
  • Published:
Oncologie

Résumé

Le développement des immunothérapies connaît un essor sans précédent dans de nombreux types tumoraux, cancer du sein inclus. De nombreuses études se sont intéressées à l’évaluation des lymphocytes infiltrant la tumeur ou TILs (tumor-infiltrating lymphocytes) comme facteur pronostique et prédictif de réponse, et il semble se dégager un sous-type de cancer du sein à prédominance lymphocytaire, dont le pronostic est meilleur. On peut supposer que ces tumeurs seraient de bonnes candidates pour l’immunothérapie. Concernant les immune checkpoint inhibitors, même si les résultats des premiers essais évaluant les anti-PD-1 sont moins spectaculaires que dans d’autres types de cancer, il existe un signal d’activité des patients pouvant bénéficier du traitement pour une durée prolongée. Parallèlement, des vaccins ciblant différents antigènes tumoraux (HER2, Tn…) sont développés et ont montré une capacité à induire une réponse immunitaire antitumorale. L’avenir est donc probablement à une association de ces vaccins aux différentes immunothérapies. Toutefois, la présence de marqueur prédictif de réponse manque pour identifier quelles patientes bénéficieraient au mieux de ces thérapies innovantes, et ce d’autant plus que le coût de ces nouveaux traitements est élevé.

Abstract

Immunotherapy development is increasing in several types of tumor, including breast cancer. A large number of studies have focused on the evaluation of tumor-infiltrating lymphocytes, or TILS, as a prognostic and predictive factor, and it seems that a breast cancer sub-type with high rates of TILS has a better prognosis. It can be assumed that these tumors would be good candidates for immunotherapy. Concerning immune checkpoint inhibitors, preliminary results from anti-PD1 administration for breast cancer are less impressive than in other types of cancer, but there are signs of activity in a small proportion of patients who may benefit from treatment over an extended period. At the same time, vaccines targeting various tumor antigens (HER2, Tn, etc.) were developed, and have shown ability to induce an anti-tumor immune response. The future is therefore to a combination of these vaccines with immunotherapy. Nevertheless, the presence of a biomarker to predict response is lacking and we need to identify which patients would benefit from these new and expansive therapies.

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Authors and Affiliations

  1. AERIO, Paris, France

    B. Verret

  2. Université Paris Diderot, 5, rue Thomas Mann, F-75013, Paris, France

    B. Verret

  3. Oncologie médicale, Iinstitut Curie, 26, rue d’Ulm, F-75005, Paris, France

    D. Loirat

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  1. B. Verret
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Correspondence to B. Verret.

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Verret, B., Loirat, D. Immunothérapie et cancer du sein. Oncologie 18, 551–558 (2016). https://doi.org/10.1007/s10269-016-2663-z

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  • DOI: https://doi.org/10.1007/s10269-016-2663-z

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