Immunotherapy in Breast Cancer: The Role of Monoclonal Antibodies
The immunotherapy is an innovative therapeutic axis in breast cancer, utilizing the capabilities of the immune system to identify and destroy cancer cells. One of the most well-known types of immunotherapy is the monoclonal antibodies, with typical example the trastuzumab (Herceptin).
What are HER2-positive breast cancers?
About 20% of breast cancers overexpress a protein called HER2 (Human Epidermal growth factor Receptor 2). These HER2-positive tumors tend to be more aggressive, with a higher ability to grow and spread.
How do monoclonal antibodies work?
Monoclonal antibodies, such as trastuzumab (Herceptin), specifically target the HER2 protein on cancer cells by binding to it. This action:
- Blocks HER2 function, slowing tumor growth
- The immune system is activated, to attack cancer cells.
- The effectiveness of other treatments is enhanced, such as chemotherapy.
The introduction of monoclonal antibodies has significantly improved survival and reduced recurrence rates in patients with HER2-positive breast cancer.
How is the treatment given?
The administration of monoclonal antibodies is done intravenously and is usually combined with chemotherapy in the initial phase of treatment. The total duration can reach 6 to 12 months, depending on the characteristics of the disease and the patient's response.
Are there side effects?
The most important possible side effect is cardiotoxicity, affecting heart function, especially when trastuzumab is combined with certain chemotherapy drugs (e.g., anthracyclines). Heart failure can occur in a small percentage of patients but is often reversible after stopping or completing therapy.
For this reason, it is necessary to have a complete cardiological check-up before starting and during treatment.
Immunotherapy today
Immunotherapy, especially monoclonal antibodies, is a cornerstone of targeted therapy for HER2-positive breast cancer. Ongoing advances in immuno-oncology are continuously introducing new drugs and strategies, offering more personalized and effective options for patients.
Remember:
- HER2-positive cancer is aggressive but now treatable with specialized treatments.
- Early diagnosis and personalized treatment are key to better outcomes.
- Talk to your oncology team about participation in clinical trials which may include new immunotherapies.
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Bibliography:
- National Cancer Institute. “Targeted Cancer Therapies.”
- Swain SM, Miles D, Kim SB, et al.
Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 study.
The Lancet Oncology. 2020;21(4):519-530.
- Tarantino P, Hamilton E, Tolaney SM, et al.
HER2-Low Breast Cancer: Pathological and Clinical Landscape.
J Clin Oncol. 2023;41(3):386-403.
- Modi S, Park H, Murthy RK, et al.
Antibody–Drug Conjugates in the Treatment of HER2-Positive Breast Cancer: A Review of the Current Landscape and Future Directions.
Clin Cancer Res. 2022;28(7):1276-1288.
- National Comprehensive Cancer Network (NCCN).
- Curigliano G, et al. (ESMO Guidelines Committee).
ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of early and locally advanced breast cancer, 2023 update.
Ann Oncol. 2023;34(10):1081-1099.
