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Immunotherapy for Breast Cancer: How It Works and Who Can Benefit
By Raveena M Prakash
Breast cancer usually remains one of the most common types of cancer diagnosed across the globe. However, the advanced cancer treatments for these types of cancers continue to evolve. Surgery, chemotherapy, and radiation therapy have been the standardized treatment approach for this cancer treatment for years. However, immunotherapy is quickly emerging as a promising approach for certain types of breast cancer.
In this blog, we’ll discover more about what immunotherapy is and how it works and who can benefit from it! Let’s get into this!
What is Immunotherapy?
Immunotherapy is an effective cancer treatment that helps the body’s immune system to recognize and fight cancer cells more effectively. Unlike traditional treatments like chemotherapy, which target both cancerous and healthy cells, immunotherapy focuses on boosting the body’s natural defenses to destroy the cancer cells effectively.
This treatment approach uses substances found in the body or created in a lab to stimulate the immune system. While in the context of this cancer, immunotherapy typically works with:
- Enhancing immune system recognition of cancer cells
- Blocking signals that prevent immune cells from destroying cancer
- Stimulating immune cells like T-cells to be more effective at destroying cancer cells.
Types of Immunotherapy for breast cancer
There are several types of Immunotherapy used for this cancer, including:
Checkpoint inhibitors:
One of the most promising forms of immunotherapy for this cancer is the use of checkpoint inhibitors. These drugs work effectively by blocking the checkpoints, including molecules on immune cells or cancer cells that can prevent the immune system from destroying cancer. PD-1 and PD-L1 inhibitors are the most commonly used in cancer treatments.
These therapies usually block the interaction between PD-1 (a protein found on immune cells) and PD-L1 (a protein that is found on tumor cells), which allows immune cells to better cognize and destroy cancer cells.
Examples: pembrolizumab (Keytruda) and atezolizumab (Tecentriq)
Monoclonal Antibodies
These are laboratory created molecules that are designed to target cancer cells. For example: trastuzumab (Herceptin) is a monoclonal antibody used to treat cancers like HER2 Positive cancers. These drugs can help the immune system identify and attack HER2 positive cancer cells.
Cancer vaccines
These vaccines are designed to stimulate the immune system to fight against cancer by teaching it to recognise specific proteins found on cancer cells. Although vaccines have been more widely used in cancers like cervical cancer, breast cancer, these vaccines show potential as part of the future immunotherapy treatments.
Adoptive cell therapy
In adoptive cell therapy, immune cells like T cells are removed from the patient or enhanced in the lab and then reinfused into the patient to better target and kill cancer cells. Adoptive cell therapy is not yet used as mainstream treatment for this cancer, but ongoing research and studies give hope for the treatment of these cancers.
How does immunotherapy work in breast cancer?
Immunotherapy works by either stimulating the body’s immune system or helping the immune system to recognize and target specific molecules on the surface of cancer cells. In most cases, these cancer cells start to ‘hide’ from the immune system by expressing the molecules that suppress the immune responses.
Immunotherapy works by:
- Blocking immune checkpoint proteins like PD-1/ PD- L1 and CTLA-4, which can turn off the immune responses.
- It helps to enhance the immune response through various other mechanisms, such as stimulating T-cells, the immune system’s primary fight against tumors.
For these cancers, immunotherapy is most effective in subtypes with specific genetic and molecular characteristics, including triple negative breast cancer (TNBC) and HER 2 positive cancer.
Who can benefit from Immunotherapy for breast cancer
Not all breast cancer cases are treated with immunotherapy. There are some factors that make the cancer cases suitable for getting treated with this treatment option. The factors may include the type of this cancer, the molecular and genetic characteristics of the tumor, and how the immune system interacts with the cancer.
The following are more likely to benefit from this treatment, including:
Triple Negative Breast Cancer
TNBC is an aggressive cancer form of breast cancer that lacks estrogen receptors (ER), progesterone receptors (PR), and HER2 protein expression. It’s often harder to treat the normal cancer treatments such as hormone therapy or HER2 targeted treatments. The TNBC usually tends to have a higher rate of mutations, which makes this suitable for immunotherapy. Pembrolizumab (Keytruda), for example: it has shown promising results in patients with advanced TNBC, especially when combined with chemotherapy.
HER2 Positive Breast Cancer
HER2-positive cancer, which often accounts for around 20% of breast cancers, has an overexpression of the protein. For example, trastuzumab (Herceptin) has long been considered a standard treatment for HER2-positive cancers. While newer forms of immunotherapy targeting HER2, such as trastuzumab-deruxtecan (Enhertu), have shown impressive results in the advanced cases of cancers.
PDL1 Expression
In some cases, tumors that express PD-L1, which is a protein that helps cancer to evade immune detection, can also be treated with PD-L1 inhibitors. If a cancer cell shows high levels of PD-L1, then checkpoint inhibitors like pembrolizumab and atezolizumab may be effective.
Advantages of Immunotherapy
Here are some of the advantages of immunotherapy, including:
- Targeted approach: Immunotherapy treatments are effective in targeting cancer cells more effectively, sparing healthy cells and potentially reducing side effects compared to chemotherapy and radiation.
- Durable responses: For some patients, immunotherapy can result in a long-lasting remission, especially if the immune system is effectively trained to recognise and attack cancer cells.
- Combination therapy: Immunotherapy often combines with other treatments like chemotherapy, radiation, or targeted therapies, which can increase its effectiveness.
Challenges and side effects
Immunotherapy represents a significant advancement in cancer treatment, especially in this type of cancer. While it does come with some challenges and side effects.
Here are some of the key challenges and side effects, including:
Side effects:
Immunotherapy can cause some immune-related side effects, including inflammation, fatigue, skin rashes, and gastrointestinal issues. In some rare cases, it can trigger autoimmune reactions.
Not suitable for all patients:
Not all breast cancer cases can be treated with immunotherapy. For example, hormone-receptive positive cancers or tumors that do not show high mutational burdens that may not respond well.
Cost:
Immunotherapy drugs can be quite expensive in nature and not all insurance plans may not cover them, which makes this treatment inaccessible for some patients.
Consult Today
Immunotherapy is changing the landscape of breast cancer treatment, offering hope for many patients who may have limited options with some traditional treatments. While this is not a standardized treatment for all. This treatment has the ability to harness and enhance the power of the immune system and provides a promising new direction, especially for subtypes like triple-negative and HER2-positive breast cancers.
At Oncare, we offer premium-quality cancer treatments, including advanced cancer surgeries at affordable price ranges with an experienced cancer specialist consultation.
If you or any loved ones of yours are diagnosed with cancer, then visit Oncare Cancer Center and book an appointment with our experienced cancer specialist today. Get an estimated cost of your cancer treatments today!
Frequently Asked Questions
Healthcare providers inject the drugs into the veins through the intravenous (IV) line. A specific treatment depends on the situation, but most patients will receive immunotherapy every three to six weeks for months up to two years.
Here are few side effects of immunotherapy, including:
- Diarrhea
- Fatigue
- Skin rash
- Thyroid issue
Immunotherapy is an effective option to improve the cure rate of survival for triple negative breast cancer. This is also an option for metastatic breast cancer.
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