Immunonkologische Ansätze beim Mammakarzinom

Background: Immunotherapeutic strategies for treatment of solid tumors have gained increasing interest in recent years. Several immune checkpoint inhibitors (ICPi) have been approved for treatment of melanoma, urothelial carcinoma, and lung cancer. Objectives: Efficacy and toxicity profile of checkpoint inhibitors in breast cancer treatment. Materials and methods: Analysis of published results of clinical trials, including conference abstracts. Results: The use of ICPi has been investigated both in metastatic and (neo)adjuvant settings, showing promising clinical efficacy and higher response rates when administered in combination with chemotherapy rather than as monotherapy. Some patients achieve long-term remission. With regard to potential biomarkers, patients with programmed cell death ligand 1 (PD-L1)-positive tumors or immune cells are most likely to respond to immunotherapy. The approval of the first ICPi atezolizumab for treatment of metastatic triple-negative breast cancer with PD-L1-positive tumor-associated immune cells is currently expected. In addition, cancer vaccines are investigated to further enhance the immune reaction against breast cancer. Conclusions: New treatment options have been made available to patients with metastatic breast cancer. Concerning toxicities, autoimmune adverse effects and endocrinopathies are particularly important.