Immunotherapy Treatment Options & Guidelines for Breast Cancer

Overview

What is immunotherapy for breast cancer?

Immunotherapy is a relatively new breast cancer treatment that uses your immune system to identify, target and cripple breast cancer cells. While chemotherapy and radiation therapy are still standard breast cancer treatments, healthcare providers are optimistic about immunotherapy’s potential to treat recurring breast cancer, metastatic breast cancer and triple-negative breast cancer.

How does immunotherapy work?

To understand how immunotherapy works, it helps to understand how breast cancer develops. Breast cancer happens when something disrupts the way your body produces the cells that make up your breast glands, ducts and tissues.

Like all cells, your breast cells are continually dividing and reproducing. Think of a bathtub being filled with soapy bubbles that divide and subdivide until the tub fills. If something speeds up bubble production, the tub overflows. When something speeds up breast cell production, your breast cells turn into a mass of tissue or tumor. These tumors can be benign or cancerous. When you pull the plug on a tub of bubbles, they flow away. Likewise, breast cancer treatment attempts to pull the plug on cancer cells.

Radiation therapy does that with high-powered X-rays. Chemotherapy does that with drugs. Immunotherapy does that with what’s called active or passive immunotherapies.

What are active immunotherapies?

Active immunotherapies essentially push your immune system to do more to respond to your cancer. Healthcare providers create these immunotherapies by examining your cancer cells for antigens. Antigens are toxins or foreign substances. When your immune system runs into an antigen, it goes after the antigen. By identifying cancer cell antigens, providers can create drugs that focus your immune system on the cancer cells.

What are passive immunotherapies?

Passive immunotherapies are lab-made drugs that improve your immune system’s existing cancer-fighting tools. Immune checkpoint inhibitors are one example of passive immunotherapy.

Your immune system includes proteins called checkpoints that keep your immune system from coming on too strong and doing damage. Cancer-fighting cells that run into immune checkpoints know to move on to other targets. Unfortunately, cancer cells sometimes use these checkpoints to duck your cancer-fighting cells. Immune checkpoint inhibitors are drugs that essentially force your cancer cells into the open.

Does breast cancer respond to immunotherapy?

In short, it’s too soon to say how all the various types and stages of breast cancer will be affected by immunotherapy.

The U.S. Food and Drug Administration (FDA) has approved two immunotherapies. One treats early-stage triple-negative breast cancer. The other is limited to certain metastatic breast cancers. (Metastatic breast cancer is cancer that has gone through metastasis, meaning it has spread from your breast to another area of your body. It’s also known as Stage IV breast cancer.)

Meanwhile, there are hundreds of clinical trials involving immunotherapy, particularly looking at how immunotherapy and chemotherapy could be used together to treat breast cancer.

Procedure Details

How is immunotherapy for breast cancer administered?

Immunotherapy drugs are given intravenously. Your treatment depends on your situation, but immunotherapy is usually administered every few weeks. Immunotherapy drugs are used along with chemotherapy to treat breast cancer.

Risks / Benefits

What are the benefits of using immunotherapy to treat breast cancer?

Immunotherapy’s main benefit is offering another way to treat triple negative breast cancer.

What are the risks of using immunotherapy to treat breast cancer?

Like many cancer treatments, immunotherapy has several side effects. More common side effects are:

Other, more serious side effects occur less often:

  • Infusion reactions: Some people might have an infusion reaction while getting these drugs. This might feel like an allergic reaction. You might have fever, chills, itchy skin, feel dizzy or that your face is flushed. You might have trouble breathing or begin to wheeze.
  • Autoimmune reactions: Sometimes your immune system starts to attack other areas of your body. That’s why there are safeguards on your immune system. Immunotherapy removes one of those safeguards, making your body more vulnerable to autoimmune reactions that can cause life-threatening problems in your organs.

Tell your healthcare provider right away if you have either of these reactions. They might decide to stop treatment temporarily.

Recovery and Outlook

What is the prognosis for breast cancer treated with immunotherapy?

Immunotherapy has the potential to do more to help people who have early-stage triple-negative breast cancer and some forms of metastatic breast cancer. Immunotherapy treatments will continue to evolve as researchers learn more about ways the body’s immune system can slow breast cancer’s progress.

When to Call the Doctor

When should I contact my healthcare provider?

You should contact your provider if you have an extreme reaction to immunotherapy.

A note from Cleveland Clinic

Immunotherapy does more than treat breast cancer. It brings hope to people who have rare hard-to-treat types of breast cancer. It is too soon to say how immunotherapy will change the way healthcare providers treat breast cancer. But it’s not too soon to be hopeful about its potential. There are hundreds of clinical trials assessing different ways immunotherapy might be used to treat breast cancer. Ask your healthcare provider whether immunotherapy might be an appropriate treatment for your breast cancer.

Last reviewed by a Cleveland Clinic medical professional on 10/21/2021.

References

  • Adams S, Gatti-Mays ME, Kalinsky K, Korde LA, Current Landscape of Immunotherapy in Breast Cancer: A Review. (https://pubmed.ncbi.nlm.nih.gov/30973611/) JAMA Oncol. Accessed 10/21/2021.
  • Breastcancer.org. Immunotherapy. (https://www.breastcancer.org/treatment/immunotherapy) Accessed 10/21/2021.
  • Simonian M, Ghaffari MH, Negahdari B. Immunotherapy for Breast Cancer Treatment. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183391/#__ffn_sectitle) Iran Biomed J. Accessed 10/21/2021.

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