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Santoni M, Romagnoli E, Saladino T, Foghini L, Guarino S, Capponi M, Giannini M, Cognigni PD, Ferrara G, Battelli N. Triple negative breast cancer: Key role of Tumor-Associated Macrophages in regulating the activity of anti-PD-1/PD-L1 agents. Biochim Biophys Acta Rev Cancer 2017; 1869:78-84. [PMID: 29126881 DOI: 10.1016/j.bbcan.2017.10.007] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 12/31/2022]
Abstract
Triple-negative breast cancer (TNBC) is associated with a poor prognosis, due to its aggressive behaviour and lack of effective targeted therapies. Immunocheckpoint inhibitors, such as anti-programmed cell death 1 (PD-1) and anti-PD-ligand(L)1 agents, are in course of investigation in TNBC, used alone or in combination with other systemic or local approaches. However, the high cost of these drugs and the lack of validated predictive biomarkers support the development of strategies aimed to overcome resistance and optimize the efficacy of these approaches. Tumor-Associated Macrophages (TAMs) derive from peripheral blood monocytes recruited into the TNBC microenvironment and, in response to several stimuli, undergo M1 (classical) or M2 (alternative) activation. In TNBC, TAMs promote tumor growth and progression by several mechanisms that include the secretion of inhibitory cytokines, the reduction of effector functions of Tumor Infiltrating Lymphocytes (TILs) and the promotion of Regulatory T cell (Treg). Interestingly, TAMs have been shown to directly and indirectly modulate PD-1/PD-L1 expression in tumor environment. On this scenario, several TAM-centered strategies have been proposed, such as the suppression of TAM recruitment, the depletion of their number, the switch of M2 TAMs into antitumor M1 phenotype and the inhibition of TAM-associated molecules. In this review, we will illustrate the activity of TAMs and associated molecules in TNBC, focusing on their role in modulating the expression of PD-1/PD-L1 and on the emerging TAM-tailored strategies for TNBC patients.
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Affiliation(s)
- Matteo Santoni
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy.
| | | | - Tiziana Saladino
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
| | - Laura Foghini
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
| | - Stefania Guarino
- U.O. Oncologia Medica Ospedale Santa Maria della Misericordia, Area Vasta n. 1, Urbino, Italy
| | - Marco Capponi
- UOS Radiologia Senologica, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
| | - Massimo Giannini
- UOC Radioterapia Oncologica, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
| | | | - Gerardo Ferrara
- Anatomic Pathology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
| | - Nicola Battelli
- Oncology Unit, Macerata Hospital, via Santa Lucia 2, Macerata, Italy
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