Breast cancer is the most common cancer among women around the world with over two million new cases diagnosed in 2018. Different types of breast cancer have been mainly distributed based on the expression of specific proteins such as Estrogen Adceptor (ER), Adcept Progesterone (PR) and Her2 (human epidermal growth factor receptor 2).
Drugs have been developed specifically to target these proteins on cancer cells. For example, women with positive ER breast cancer are treated with a drug called Tamoxifen that blocked the ER action and has given millions of women hope. However, some cancers do not express any of these three proteins (ER, PR or Her2) and are classified as the Breast Cancer Triple Negative (TNBC).
TNBC is an incredible form of breast cancer and those who suffer from it have too much chance of survival. It is more likely to occur in younger women. This type of breast cancer accounts for around 15% of the total breast cancer cases. Its cases in India, however, are higher (27.9%) compared to other regions of the world.
Traditionally, chemotherapy that involves administering a range of drugs to prevent cancer cells from uncontrolled growth is the care standard for TNBC. Despite the treatment, TNBC patients show high rates of re-appearance of the disease that unfortunately result in unexpected death. Therefore, there is an urgent need for better therapies when handling TNBC.
Immunotherapy, which promotes the body's immune system, has shown a lot of pledge in the treatment of some cancers and is now recognized as a potential therapeutic approach in TNBC. It uses the body or synthesis that produces a synthetic that improves or can restore a immune system.
One type of immunotherapy recently developed uses a class of drugs known as check inhibitors, which use key face molecules on T cells, which are a major weapon of the human body's immune system. James P Allison and Tasuku Honjo were awarded to the Nobel Prize in Physiology or Medicine in 2018 for their work that led to the discovery of new molecules that led to the development of immunotherapy.
A new study recently published by the New England Journal of medicine (NEJM) Peter Schmid of Barts Cancer Institute, Queen Mary, University of London, and colleagues, found that combine immunotherapy with chemistry could improve the result for some negative triplex shorter breast cancer patients.
There are more than 900 non-treated metastatic patients (where the cancer has spread to other parts of the body such as the lungs). TNBC was registered in a stage III clinical trial and was randomly assigned to accept Nab-Paclitaxel, a chemotherapeutic drug used to treat breast cancer either with placebo (no immunotherapy drug) or in combination with Atezolizumab, a drug that is belongs to a drug prevention class preventor immunotherapy.
In the body, immune T cells express a surface molecule of the PD-1 name that can be connected to another molecule of the PD-L1 name that is present on other cells. This annex connects to T cells that the other cell is not destroyed and thus prevents them from being attacked by the immune system. Some cancer cells take advantage of this in a Trojan equation way by having more PD-L1 molecules on their faces and thus escaping an immune attack. The anthotheotherapy drug, Atezolizumab, works by blocking PD-L1 molecules on cancer cells and thus prevents them from transferring incorrect signals to immune cells.
However, there are significant disadvantages in this study. It was found that the combination therapy increases the average survival to 25 months against 15.5 months. But cancer cells had to have a high level of PD-L1 molecules on their attitude that could be the case in every patient. This means that the PD-L1 receptor status needs to be checked in patients before the start of the therapy.
In addition, side effects associated with combined therapy must be considered more serious than for single agent chemotherapy. The cost of personal immunotherapy could also be extremely high with one round of therapy being Rs. 1 lakh i Rs.13 lakh.
Immunotherapy continues to evolve in the development of nations such as India, and is now being offered in a few treatment centers and also mainly for solid tumors such as prostate, breast, kidney, colon, hepatocellular, colorectal, oral, the lungs and ovaries. Although this is just the first major clinical trial that involves immunotherapy and that more studies are needed, the positive findings shine a ray of hope for TNBC patients.