Immunotherapy without chemotherapy for breast cancer seems to work well – Antoni van Leeuwenhoek

Triple-negative breast cancer is an aggressive type of breast cancer that often grows quickly and spreads more quickly than other types of breast cancer. Around 2,000 to 3,000 women receive this diagnosis in the Netherlands each year. Standard treatment currently consists of four types of chemotherapy combined with immunotherapy. However, it is still unclear which patients benefit from this combined treatment and which patients are overtreated. In the latter case, patients are unnecessarily exposed to too many treatments, which may cause unnecessary side effects.

Internal medicine oncologist and researcher Marleen Kok: “We already knew from previous international research that adding immunotherapy to standard chemotherapy improves survival in early-stage triple-negative breast cancer. The BELLINI study could offer another option for these patients. ” In the study, the researchers show that immunotherapy with the drugs nivolumab and ipilimumab can be effective in treating triple-negative breast cancer. These agents strengthen the immune system, which helps prevent overtreatment and side effects of chemotherapy. The results of the study were presented on September 16 by PhD student and oncologist-in-training Iris Nederlof at the European Society of Medical Oncology (ESMO) conference in Barcelona and published in Barcelona. Natural medicine.

Many immune cells

In the first part of the study, patients received treatment with nivolumab or a combination of nivolumab and ipilimumab four weeks before chemotherapy. In some patients the immune system was visibly activated and in others even shrinkage of the tumor was observed. This effect was particularly evident in patients with high numbers of immune cells, also known as tumor infiltrating lymphocytes (TILs). This group seems to respond well to immunotherapy.

In the second part of the study, patients with many immune cells received combined immunotherapy six weeks before chemotherapy. After this treatment, no cancer cells were found during surgery in one third of the patients. These patients did not receive any other chemotherapy after immunotherapy.

The first time

“The fact that we are now seeing that a third of this patient group has already achieved a complete response with just 6 weeks of immunotherapy without chemotherapy may be the first step towards a cure more personal on triple-negative breast cancer.”

Another promising finding is that the treatment caused a significant reduction in circulating tumor DNA (ctDNA), an indicator of the presence of cancer cells in the body. In more than twenty percent of patients, the ctDNA disappeared completely after treatment, suggesting that the immunotherapy was effective in clearing cancer cells even without chemotherapy.

This study shows that short-term immunotherapy without chemotherapy may be a promising option for a selected group of patients with triple-negative breast cancer, especially for patients with a high number of immune cells. Although these results are promising, the researchers emphasize that further research is needed on the treatment of triple-negative breast cancer with immunotherapy. Larger studies are needed where patients receiving immunotherapy are followed for a longer period of time.

“A similar study has now been started in France with only immunotherapy and in America two major initiatives to give less chemotherapy if the immunotherapy works well. This is very important because now that treatment is improving and we are treating more people, tailor-made treatment is very important because in addition to healing, quality of life is also important.”

The research described in this scientific publication was made possible with the support of the American Association for Cancer Research (AACR).