三阴性乳腺癌免疫治疗耐药机制的研究进展

Research progress on immunotherapy resistance mechanisms of triple-negative breast cancer

目的 三阴性乳腺癌(Triple-negative breast cancer, TNBC)由于具有较高肿瘤突变负荷(TMB)和肿瘤浸润淋巴细胞,可受益于免疫治疗。尽管免疫治疗作为TNBC的重要治疗策略已取得突破,但最近的一些临床数据表明,很大一部分患者对免疫治疗表现出耐药,或对治疗有效果的患者出现进一步复发或进展。这些预后不良的主要原因是其复杂的内在或外在免疫逃逸机制,可能是由抗原呈递异常、免疫抑制性肿瘤微环境、与其他免疫检查点相互作用以及肿瘤细胞信号传导的异常激活引起的。然而目前对于TNBC免疫治疗耐药机制的研究尚不完善。本文将对免疫治疗所面临的挑战及TNBC对免疫治疗产生耐药性的潜在机制进行综述。

Triple-negative breast cancer(TNBC)can benefit from immunotherapy because of its higher tumor mutational burden(TMB)and tumor-infiltrating lymphocytes.Although immunotherapy has made breakthroughs as an important treatment strategy for TNBC,recent clinical data suggest that a proportion of patients exhibit resistance to immunotherapy,or those who are effective in treatment experience further recurrence or progression.The main reason for these poor prognosis is complex internal or external immune escape mechanisms,which may be caused by abnormal antigen presentation,immunosuppressive tumor microenvironment,interactions with other immune checkpoints,and abnormal activation of tumor cell signaling.However,the research on the resistance mechanism of TNBC immunotherapy is still incomplete.This article will provide a review of the challenges faced by immunotherapy and the potential mechanisms of TNBC develops resistance to immunotherapy.