Review Article

Immunotherapy in Breast Cancer Patients: A Focus on the Use of the Currently Available Biomarkers in Oncology

Author(s):

Carmen Criscitiello, Elena Guerini-Rocco, Giulia Viale, Caterina Fumagalli, Elham Sajjadi, Konstantinos Venetis, Roberto Piciotti, Marco Invernizzi, Umberto Malapelle and Nicola Fusco*   Pages 787 - 800 ( 14 )

Abstract:

Immune Checkpoint Inhibitors (ICIs) have remarkably modified the way solid tumors are managed, including breast cancer. Unfortunately, only a relatively small number of breast cancer patients significantly respond to these treatments. To maximize the immunotherapy benefit in breast cancer, several efforts are currently being put forward for the identification of i) the best therapeutic strategy (i.e. ICI monotherapy or in association with chemotherapy, radiotherapy, or other drugs); ii) optimal timing for administration (e.g. early/advanced stage of disease; adjuvant/ neoadjuvant setting); iii) most effective and reliable predictive biomarkers of response (e.g. tumor-infiltrating lymphocytes, programmed death-ligand 1, microsatellite instability associated with mismatch repair deficiency, and tumor mutational burden). In this article, we review the impacts and gaps in the characterization of immune-related biomarkers raised by clinical and translational research studies with immunotherapy treatments. Particular emphasis has been put on the documented evidence of significant clinical benefits of ICI in different randomized clinical trials, along with preanalytical and analytical issues in predictive biomarkers pathological assessment.

Keywords:

Breast cancer, biomarkers, immunotherapy, TILs, PD-L1, mismatch repair, microsatellite instability, tumor mutational burden.

Affiliation:

Department of Oncology and Hemato-Oncology, University of Milan, Department of Oncology and Hemato-Oncology, University of Milan, Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Department of Oncology and Hemato-Oncology, University of Milan, Department of Oncology and Hemato-Oncology, University of Milan, Department of Oncology and Hemato-Oncology, University of Milan, Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Viale Piazza D'Armi 1, Novara, Department of Public Health, University of Naples Federico II, Naples, Division of Pathology, IEO, European Institute of Oncology IRCCS, University of Milan, Via Giuseppe Ripamonti 435, 20141, Milan

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