Breast cancer is the most common malignant tumour in women and the second cause of death in women from malignant tumours. Approximately 15,000 new cases are reported each year. Treatment is mainly based on surgical methods and radiotherapy, and in recent years we have new therapies with very promising results. One such method is immunotherapy, the main aim of which in breast cancer is the use of monoclonal antibodies.
Anti-HER2 treatment
Trastuzumab
Trastuzumab is a monoclonal antibody that blocks HER2 receptors. By blocking the receptor, it inhibits excessive proliferation (proliferation) of cells that overexpress it. Patients with advanced breast cancer with HER2+ features benefit greatly from treatment with this antibody, either as monotherapy or in combination with chemotherapy. Treatment with trastuzumab should be initiated in early generalised breast cancer. In Poland, trastuzumab treatment is only reimbursed until progression. During therapy, it is important to be aware of cardiovascular side effects and regular cardiovascular checks.
Pertuzumab
A recombinant, humanised monoclonal antibody that leads to inhibition of intracellular signalling. The consequence of stopping signal transduction is the arrest of tumour cell growth and apoptosis (death). The drug can only be used in patients with HER2-positive tumour status as determined by histochemical examination.
Lapatinib
This is an oral, small-molecule drug that enters the tumour cell and inhibits two receptor proteins with tyrosine kinase activity. The signals sent by these receptors cause tumour growth and progression. In HER2+ patients with metastatic breast cancer, the addition of lapatinib to standard therapy slowed tumour growth. Internationally, the combination of trastuzumab with lapatinib is used in patients with progression during treatment with trastuzumab; this prolongs progression-free survival and overall survival compared with treatment with lapatinib alone. This drug cannot be used in patients with impaired left ventricular ejection fraction, malabsorption and those taking drugs that cause drug interactions with it.
photo: panthermedia
Trastuzumab - emtastine
This drug combination is not yet available in EU countries, but is registered in the United States. It is the first preparation of a monoclonal antibody conjugated with a cytotoxic drug. In patients with progression treated with taxoids and trastuzumab, treatment with this drug prolongs time to progression and overall survival, with lower toxicity than other chemotherapy regimens.
The role of immunotherapy in the treatment of breast cancer is increasing. Contemporary trends in cancer immunotherapy are generally moving in several directions: achieving an increasingly selective antitumour effect to spare tissues not affected by the condition, reducing side effects, particularly with chemotherapy, inducing an antitumour response by influencing mechanisms that regulate the immune response.
