Biomarker Shows Potential to Predict Immunotherapy Benefits for Breast Cancer Patients

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A biomarker that has been shown to be a predictor of response to immunotherapies in patients with melanoma also has clinical relevance for patients with breast cancer, according to a new study published in Clinical Cancer Research, a journal of the American Association for Cancer Research.

The study demonstrated that this biomarker, a molecule called major histocompatibility complex (MHC-II) class II protein, has the potential to be a predictor of the benefits of immunotherapy with two types of breast cancer – early stage triple negative breast cancer (TNBC) and high risk, estrogen receptor positive (HR +) breast cancer when expressed on breast cancer cells. Although immunotherapies will probably soon be prescribed along with chemotherapy for these breast cancers before surgery, most patients do not need to add immunotherapy to achieve a response to treatment. Without an optimal biomarker, clinicians do not have a reliable way to discern which patients need immunotherapy and which do not.

Clinical testing for MHC-II expression could protect breast cancer patients who do not need immunotherapy from possible treatment complications and additional costs. Immunotherapies are expensive and associated with significant toxicity.

Justin Balko, PharmD, PhD, associate professor of medicine and pathology, microbiology and immunology, designed and designed the study.

“These findings are of particular interest to us because, if validated, they could provide a better way to personalize therapy for breast cancer patients. So far, typical biomarkers like PD-L1 expression and the number of immune cells in the tumor have not worked. a good job of identifying patients who need immunotherapy, ”said Balko, lead author of the study.

Paula Gonzalez Ericsson, lead author of the study, added that “the test can be easily performed on patient tissue samples obtained for diagnosis without requiring additional intervention.”

Balko and his colleagues analyzed tissue samples donated by three patient cohorts:

  • patients with breast cancer not treated with immunotherapy
  • patients with TNBC treated with durvalumab immunotherapy and standard chemotherapy
  • patients with HER2-negative breast cancer treated with either standard chemotherapy or standard chemotherapy plus pembrolizumab immunotherapy.

They determined that MHC-II is expressed in a subset of primary breast cancers TNBC and HR +, and that tumor expression of MHC-II is associated with the response to standard chemotherapy plus durvalumab or pembrolizumab, but not to standard neoadjuvant chemotherapy alone.

“The results of association with response in high-risk, early-stage HR + patients suggest that MHC-II may be a useful tool in a larger breast cancer setting and this area would benefit from further study. more in-depth, “said co-lead author Kim Blenman, PhD, MS, assistant professor of medicine at Yale University.

The study is considered the first to assess and demonstrate the predictive ability of MHC-II tumor for specific benefit to immunotherapy in breast cancer patients. The researchers also noted that MHC-II has the potential to be a pan-cancer biomarker predictor for anti-PD-1 or anti-PD-L1 immunotherapies since its clinical relevance has been demonstrated with melanoma, cancer breast and Hodgkin’s lymphoma in this study. and previous studies. However, they are asking for a large randomized controlled trial to validate their results with breast cancer, which was based on a retrospective tissue-based analysis.


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