Novel Approaches in Cancer Study( NACS ISSN: 2637-773X, Impact Factor:0.637)

Immune Checkpoint Inhibitors in Triple Negative Breast Cancer- Cancer Publishers                                                            

Immune Checkpoint Inhibitors in Triple Negative Breast Cancer by Ajay Dhakal in Novel  Approaches in Cancer Study

The role of immune system in treating cancer is being increasingly seen as important [1]. Cancer cells have oncogenic mutations and express neo-antigens that make them distinct from normal cells thus prone to immune recognition. However, cells of innate and adaptive immune system which recognize and destroy these cells are held in check by various molecular pathways called “immune checkpoints” [2]. Attempts have been made to block these immune checkpoints to develop anticancer immunotherapies. Blockage of Cytotoxic T Lymphocyte Antigen 4 (CTLA4) and Programmed Death 1 (PD1), the first 2 checkpoint receptors to be discovered, has been studied widely in various cancers. Bristol Myers Squibb (BMS)’s ipilimumab, a monoclonal antibody against CTLA4, was efficacious and produced a durable response against melanoma. It was approved as the standard treatment for melanoma [3-5]. BMS’s nivolumab, Merck’s pembrolizumab, and Roche’s atezolizumab are monoclonal antibodies against PD1 (nivolumab, pembrolizumab) or PD Ligand 1(PD-L1)  (atezolizumab). They are efficacious in various malignancies including melanoma, kidney cancer, nonsmall cell lung cancer, urothelial cancer, and colon cancer [6-17]. PD-L1 expression has been suggested as a predictive biomarker for these antibodies but due to lack of a single standardized assay for measuring the expression of these surface proteins and lack of consistency in trial design across different antibodies, data supporting the predictive value of PD-L1 expression are not uniform [18]. 

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