Durvalumab, tentatively named Devalumab in Chinese, belongs to a highly regarded class of drugs in immunotherapy – PD-L1 inhibitors. 2017 In 2017, Durvalumab received U.S. Food and Drug Administration (FDA) approval for marketing. Although a breast cancer indication has not yet been obtained, some small studies have initially confirmed that regimens containing Durvalumab have a role in triple-negative breast cancer.
Tumor immunotherapy is in full swing, so let’s get to know Durvalumab.
Why does it work against cancer?
Immunotherapy, by interfering with the interaction of cancer cells with the body’s immune system, is used to fight cancer.
The members of the body’s immune system T cells, are the “mainstay” that recognize tumor cells and attack them. But tumors express PD-L1 (programmed cell death protein-1 ligand), which binds to PD-1 (programmed cell death protein-1) on the surface of T cells, thus inhibiting T cells from recognizing and killing themselves, and even preventing T cells from growing (proliferating). cell growth (proliferation), leading to their death (apoptosis).
Durvalumab specifically binds to PD-L1 and prevents tumor cells from interfering with T cells, allowing T cells to regain their ability to recognize and kill tumors, thus acting as an anti-cancer agent.
Treating advanced triple-negative breast cancer: crossing the river by feeling the stones
Triple-negative breast cancer is highly immunogenic and very likely to elicit an immune response from the body, but it also evades the body’s immune action through certain mechanisms. This opens up the possibility of immunotherapy for triple-negative breast cancer.
A newly published small study in 2018 enrolled 11 of advanced patients with hormone receptor-positive breast cancer and 8 with triple-negative breast cancer.Durvalumab was combined with another immunotherapy drug, Tremelimumab (tentative Chinese name trimethoprim) It is used, yet the treatment is only 15% effective.
Notably, the patients who achieved remission above were all triple-negative breast cancers. On the flip side, also in this study, after dual immunotherapy with Durvalumab combined with Tremelimumab, the objective remission rate in triple-negative patients was 43%, a big improvement. But numbers don’t mean everything, because the numbers are small and chance cannot be ignored.
Durvalumab s treatment of triple-negative breast cancer is just getting started, and PD-1 or PD-L1 inhibitors in combination with chemotherapy, PARP inhibitors, and other immunotherapies to fight the tumor are becoming popular options.
Summary
From the available results, the PD-L1 inhibitor Durvalumab in combination with Tremelimumab has potential to treat metastatic triple-negative breast cancer, but it cannot be overly optimistic.
The drug is not currently available in China, and it is expected that as the study progresses, Durvalumab could enter China and provide more treatment options for cancer patients.