Immunotherapy for breast cancer treatment in Delhi/India

[Dr waseem abbas]

Immunotherapy definition

Immunotherapy activates the body’s own immune system to fight cancer. It kills the chemotherapy resistant cells. Immunotherapy activates T Cell as in our body which attacks the cancer cells and kills them.

Usually, breast cancer cells are resistant to immunotherapy and it works for triple negative breast cancer and now emerging data has shown that immunotherapy also works in Her2 neu positive breast cancer.

It is new hope for patients suffering from Triple negative breast cancer especially when used early.

Immunotherapy should be used early in breast cancer and not at in late stages.

How it may treat breast cancer?

Cells in the body contain proteins called immune checkpoints. These immune system regulators signal that cells are healthy.

Immune checkpoints allow the immune system to fight infected or diseased cells while preventing them from attacking healthy tissues.

The immune system is complex and involves different types of cells, including T cells, which circulate the body checking for disease or infection. These specialized cells examine other cells to identify immune checkpoints.

If the immune system does not recognize proteins within cells, it attacks them. This process is essential in allowing the body to fight diseases and infections.

Immune check point inhibitors

These are drugs that act against CTLA-4, PDL-1 and PD-1 proteins and block them to relieve the inhibitory signals on immune cells.

e.g

Atezolizumab-This drug was first approved for metastatic triple negative breast cancer which is PDL 1 positive by IHC 142. Now it is showing efficacy against early triple negative breast cancer as well and can be used up front with immunotherapy as a part of the neoadjuvant protocol.

Tecentriq inhibits PD-L1 proteins, and doctors may use it to treat:

metastatic triple-negative breast cancer (TNBC)
PD-L1-positive breast cancer
locally advanced breast cancer where surgery is not effective

Pembrolizumab – This drug has also shown efficacy against triple negative breast cancer in early stages.

Keytruda

Keytruda inhibits PD-1 proteins. Doctors may use Keytruda alongside chemotherapy to target triple-negative breast cancer that has spread to other areas of the body or has returned locally and is not treatable with surgery.

Nivolumab – is the another drug which has shown efficacy in triple negative breast cancer.

Effectiveness

Lot of questions are being asked by experts and patients about the efficacy of immunotherapy in breast cancer treatment. Initially it did not work, but what we saw we need to combine it with chemotherapy and use at early stages for TNBC.