Immunotherapy In breast cancer

What is immunotherapy?

A treatment that harnesses the body's immune system to fight cancer by activating/enhancing anti-tumour immune responses.

How does the immune system control tumour growth?

Through immune surveillance.

What are checkpoint inhibitors?

Agents that block inhibitory receptors (e.g., PD-1, CTLA-4) to restore anti-tumour T cell responses.

What is the role of trastuzumab in HER2-positive breast cancer?

It targets the HER2 receptor to inhibit signaling and activate immune-mediated cell destruction.

What is the significance of PD-L1 in triple-negative breast cancer?

PD-L1 helps the cancer evade anti-tumour immune responses.

What is the mechanism of action of CAR-T cells?

They are engineered T cells that target specific antigens on tumor cells to kill them.

What are the two main mechanisms of trastuzumab?

Inhibiting HER2 signaling and activating antibody-dependent cytotoxicity.

What is the main goal of immune checkpoint inhibitors?

To restore and enhance the body's natural anti-tumour immune response.

How does Pembrolizumab function in PD-L1+ TNBC?

It blocks the PD-1 receptor, lifting the brakes on anti-tumour T-cells.

What was the objective response rate of Pembrolizumab in the KEYNOTE-012 trial?

18.5%.

What is Tumour-Infiltrating Lymphocyte (TIL) therapy?

A treatment that extracts and expands T cells from a patient's tumour to induce an antitumour immune response.

What is the role of nivolumab in breast cancer treatment?

It is an anti-PD-1 antibody that aims to reverse T-cell exhaustion and enhance anti-tumour immunity.

What are the potential outcomes of combining Pembrolizumab with chemotherapy?

Improved responses in treating advanced triple-negative breast cancer.

What is the function of monoclonal antibodies in cancer immunotherapy?

They specifically target molecular markers on cancer cells, enhancing immune responses.

What are the challenges associated with CAR-T cell therapy?

Safety concerns like cytokine release syndrome and identifying targets specific to cancer cells.

What does the term 'immunosuppressive microenvironment' refer to?

Tumours develop mechanisms to evade immune destruction by creating a hostile environment for immune cells.

What is the primary action of checkpoint inhibitors like Ipilimumab?

To block CTLA-4 to enhance T-cell activation and proliferation.

What percentage of metastatic breast cancers express PD-L1?

Up to 40%.

How does trastuzumab induce antibody-dependent cell-mediated cytotoxicity (ADCC)?

By linking HER2+ cancer cells to immune cells, which then kill those cancer cells.

What is the advantage of using immunotherapy in cancer treatment?

It can lead to durable responses by optimizing the immune system's ability to target tumours.

How do oncolytic viruses work in immunotherapy?

They selectively replicate in and kill tumour cells, triggering a systemic anti-tumour immune response.

What role do predictive biomarkers play in immunotherapy?

They help to stratify patients who may benefit from specific immunotherapies.

What is a significant benefit of CAR-T cells in treating hematologic cancers?

They can elicit dramatic responses in cancers resistant to other therapies.

What clinical evidence supports trastuzumab in HER2+ breast cancer?

It shows significantly improved response rates and survival when added to chemotherapy.

What is the main effect of PD-1 ligation on T-cells?

It transmits inhibitory signals that dampen T-cell effector function.

What innovative approach is being researched in combination with TIL therapy?

Combining with checkpoint inhibitors or adoptive NK cell therapy.

Why do checkpoint inhibitors represent a novel treatment approach in metastatic breast cancer?

They aim to reinvigorate the immune response against cancer cells that evade destruction.

How does pembrolizumab impact T-cell exhaustion?

It blocks the inhibitory signal from PD-L1, allowing T-cells to function effectively.

What is the role of trastuzumab in altering HER2 signaling pathways?

It prevents receptor dimerization, inhibiting crucial signaling pathways for tumor growth.

What clinical outcomes are associated with the use of immune checkpoint inhibitors?

Durable responses and improved outcomes in various cancer types.