| Breast cancer is the most common tumor in women,and has long been the first cancer incidence in women.It is one of the key reasons threatening women’s life and health.In the past 30 years,new anticancer drugs have sprung up.The development of diagnosis and treatment has reduced the mortality of breast cancer by 39%.However,the fight against breast cancer still faces many problems and challenges,and it is urgent to find new and reasonable treatment methods.With the development of immunology and biology,immunotherapy has become another important treatment for breast cancer after traditional chemotherapy,radiotherapy and surgery for a long time.In the tumor microenvironment,antigen stimulated T lymphocytes can not be activated effectively due to the existence of a variety of immune checkpoints,and immune checkpoint inhibitors plays a key role in the occurrence and development of tumor.The identification of immunosuppressive pathways leads to significant improvements in immunotherapy.Most of the treatments mainly target the immune checkpoint molecules such as lymphocyte activating gene-3(LAG-3),cytotoxic T lymphocyte associated antigen-4(CTLA-4)and programmed death receptor-1(PD-1 / PD-L1).However,it is uncertain whether the sensitivity of different immunosuppressants to different types of breast cancer is different.Therefore,it is of great significance to clarify the therapeutic effect of different types of breast cancer in the application of immunosuppressants..In order to clarify this problem,the main contents of this research are as follows:1.To observe the therapeutic effect of three kinds of immune checkpoint inhibitors on breast cancerIn order to understand the therapeutic effect of different immune checkpoint inhibitors in the treatment of breast cancer patients,the treatment effect of three kinds of immune checkpoint inhibitors in the treatment group and the control group(conventional chemotherapy group)were statistically analyzed,and the results showed that the objective remission rate in the control group was 20%.The objective response rate of PD-1/PD-L1 study group was 55%,which was significantly higher than that of control group(P<0.05).The objective response rate of CTLA-4 group was 50%,which was significantly higher than that of control group(P<0.05).The objective response rate of LAG-3 group was 40%,which was significantly higher than that of control group(P<0.05).Compared with the control group,the effective rates of the three kinds of immune checkpoint inhibitors were all increased,with statistically significant differences(P<0.05),indicating that the three kinds of immune checkpoint inhibitors can improve the therapeutic efficacy of breast cancer,but there was no significant difference among the three kinds of immune checkpoint inhibitors.2.Effect of immune checkpoint inhibitors on general status of breast cancer patients compared with traditional treatmentIn order to understand the three kinds of immune checkpoint inhibitors in the treatment of patients with breast cancer,whether also have an effect on the patient’s general condition,such as body weight,heart rate,blood pressure,we observed the immune checkpoint inhibitors for the treatment of breast cancer patients after general status,results show that in groups of immune checkpoint inhibitors treatment,the body weight,heart rate and blood pressure there is no obvious difference with control group.There was no statistical significance(P>0.05).This suggests that immune checkpoint inhibitors have no significant effect on the general status of breast cancer patients.3.Comparison of serum immunoglobulin levels before and after immune checkpoint inhibitors and traditional treatmentIn order to observe whether immune checkpoint inhibitors can improve B cell function compared with traditional treatment methods,we combined three kinds of immune checkpoint inhibitors and the control group to observe.The results showed that compared with the control group,the level of Ig G in the study group was higher than that in the control group after treatment(P < 0.05),while there was no significant difference in other types of antibodies including Ig A,Ig M and Ig E.It is suggested that immune checkpoint inhibitors can promote the secretion of Ig G antibody by B cells in patients with breast cancer,enhance the humoral immune response,participate in the anti-tumor immune response or improve the ability of anti infection.4.Inhibitory effect of three kinds of immune checkpoint inhibitors on tumor size in TNBC and non TNBC patientsIn order to further understand the therapeutic effect of three kinds of immune checkpoint inhibitors in the treatment of different types of breast cancer patients,we observed the changes of tumor size in triple negative breast cancer(TNBC)and non triple negative breast cancer(non TNBC)patients after treatment with three kinds of immune checkpoint inhibitors.The results showed that PD-1 / PD-L1 immune checkpoint inhibitors significantly reduced the tumor size(The product of larger diameter with larger vertical diameter of the tumor was reduced by more than 50%)in TNBC patients compared with non TNBC patients(P < 0.05)。 However,CTLA-4 and LAG-3 immunosuppressants showed no significant difference between TNBC and non TNBC patients,and there was no significant difference in tumor size(P >0.05).5.The effect of three kinds of immune checkpoint inhibitors on the recurrence of TNBC and non TNBCIn order to find out whether three kinds of immunosuppressants can significantly inhibit the recurrence of different types of breast cancer,we followed up the recurrence of breast cancer in discharged patients after treatment.The results showed that PD-1 /PD-L1 and CTLA-4 immunosuppressants could improve the pathological remission rate(PCR rate)in TNBC patients,but for luminal a and luminal B breast cancer However,the PCR rate of LAG-3 immunosuppressant in TNBC and non TNBC patients was not significantly improved.6.Adverse drug reactions of three kinds of immune checkpoint inhibitors in the treatment of breast cancer patientsIn order to determine whether three kinds of immune checkpoint inhibitors can cause adverse drug reactions in the treatment of breast cancer patients,the adverse drug reactions of patients after treatment were observed,including grading,death,drug withdrawal,dose adjustment,immune related adverse events and infusion reactions.The results are shown that the incidence of adverse reactions of three kinds of immune checkpoint inhibitors combined with chemotherapy is similar to that of chemotherapy alone in all types of breast cancer.But its long-term effect needs further follow-up observation.Conclusion1.Immune checkpoint inhibitors are more effective than traditional chemotherapy in the treatment of breast cancer。2.Immune checkpoint inhibitors can improve Ig G level in breast cancer patients。3.Different immune checkpoint inhibitors have different therapeutic effects on TNBC and non TNBC patients。Immune checkpoint inhibitors are safe and effective in the treatment of metastatic breast cancer,which is a new clinical treatment strategy with development potential and worthy of study and promotion. |
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