If we build it they will come: targeting the immune response to breast cancer

Margaret E. Gatti-Mays, Justin M. Balko, Sofia R. Gameiro, Harry D. Bear, Sangeetha Prabhakaran, Jami Fukui, Mary L. Disis, Rita Nanda, James L. Gulley, Kevin Kalinsky, Houssein Abdul Sater, Joseph A. Sparano, David Cescon, David B. Page, Heather McArthur, Sylvia Adams, Elizabeth A. Mittendorf

Research output: Contribution to journalReview articlepeer-review

130 Scopus citations


Historically, breast cancer tumors have been considered immunologically quiescent, with the majority of tumors demonstrating low lymphocyte infiltration, low mutational burden, and modest objective response rates to anti-PD-1/PD-L1 monotherapy. Tumor and immunologic profiling has shed light on potential mechanisms of immune evasion in breast cancer, as well as unique aspects of the tumor microenvironment (TME). These include elements associated with antigen processing and presentation as well as immunosuppressive elements, which may be targeted therapeutically. Examples of such therapeutic strategies include efforts to (1) expand effector T-cells, natural killer (NK) cells and immunostimulatory dendritic cells (DCs), (2) improve antigen presentation, and (3) decrease inhibitory cytokines, tumor-associated M2 macrophages, regulatory T- and B-cells and myeloid derived suppressor cells (MDSCs). The goal of these approaches is to alter the TME, thereby making breast tumors more responsive to immunotherapy. In this review, we summarize key developments in our understanding of antitumor immunity in breast cancer, as well as emerging therapeutic modalities that may leverage that understanding to overcome immunologic resistance.

Original languageEnglish (US)
Article number37
Journalnpj Breast Cancer
Issue number1
StatePublished - Dec 1 2019

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)


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