2018年7月16日，美国乳腺外科医师学会和肿瘤外科学会官方期刊《肿瘤外科学年鉴》在线发表宾夕法尼亚大学佩雷尔曼医学院、南佛罗里达大学莫菲特癌症中心的综述：免疫疗法终于来到乳腺癌治疗门前。

免疫疗法正在快速发展，已经成为黑色素瘤、肺癌、膀胱癌和遗传性结肠癌的主要治疗方法，虽然乳腺肿瘤淋巴细胞的强烈应答可以提高治疗效果并且预测长期生存，但是乳腺癌仍然尚未经历细胞免疫学重大突破。

单克隆抗体形式的免疫疗法，例如曲妥珠单抗和帕妥珠单抗，通过抗体依赖型细胞毒性，已经对HER2阳性乳腺癌治疗产生了显著影响。现有证据表明，免疫检查点抑制剂以及其他细胞疗法正将开始改善三阴性乳腺癌和HER2阳性乳腺癌的结局，尤其与标准疗法联合时。

因此，疗法万千种，浮云莫去求；免疫若彩虹，遇上方知有。虽然迄今为止，免疫疗法仅使少数患者获益，但是大量临床研究正在确定免疫疗法可能对乳腺癌治疗发挥的相对作用。当免疫疗法来到门前的时候，我们要做的事情是选择相信：相信科学，相信医生，相信自己，也要相信因果。

Ann Surg Oncol. 2018 Jul 16. [Epub ahead of print]

Immunotherapy for Breast Cancer is Finally at the Doorstep: Immunotherapy in Breast Cancer.

Lucy M. De La Cruz, Brian J. Czerniecki.

University of Pennsylvania Perelman, Philadelphia, USA; H. Lee Moffitt Cancer Center, Tampa, USA.

BACKGROUND: Although immunotherapy is making rapid inroads as a major treatment method for melanoma, lung, bladder, and hereditary colon cancer, breast cancer (BC) remains one of the tumors yet to experience the cellular immunology explosion despite the fact that heavy lymphocyte responses in breast tumors improve response to therapy and can predict for long-term survival.

RESULTS: Immunotherapies in the form of monoclonal antibodies such as trastuzumab and pertuzumab have had an impact on HER2-positive breast cancer (HER2+BC) treatment through antibody-dependent cellular cytotoxicity. Current evidence suggests that checkpoint inhibitors and other cellular therapies are at the doorstep of improving outcomes in triple-negative BC (TNBC) and HER2+BC, especially when combined with standard therapies.

CONCLUSIONS: Although this approach has benefitted small numbers of patients to date, numerous clinical trials are underway to define the relative role immunotherapy may play in the treatment of BC.

DOI: 10.1245/s10434-018-6620-5