Treatment outcome in a patient with triple-negative breast cancer using adoptive immunotherapy

Breast cancer (BC) is the most common malignant neoplasm in women. Adoptive immunotherapy (AIT) using activated lymphocytes is a promising approach to the treatment. Patient O., 63 years old, was diagnosed in October 2021 with infiltrating ductal carcinoma of left breast T3NxM0, Grade 2, triple negative subtype, CHEK-2 associated. According to PET/CT, the tumor size was 43 ´ 21 mm. AIT with cytokineinduced killers (CIK) was administered. In order to produce CIK, mononuclear cells were isolated from peripheral blood and cultured in presence of cytokines for 10-14 days. AIT was performed by intradermal injections paravertebrally once a week up to present date. In the course of AIT, PET/CT, MRI, ultrasound and immunophenotyping of blood lymphocytes were performed. 7 courses of AIT were administered since November 2021. Six months after starting AIT, positive dynamics was noted as proven by PET/CT data: a decreased activity of tumor in left mammary gland (LMG) with SUVmax of 16.76 (previously, SUVmax 28.74) while maintaining the size. Moreover, previously identified signs of osteoblastic changes in spine at Th12 level were not detected. According to PET/CT results in November 2022, a slight increase in size of LMG formation up to 49 ´ 35 mm (SUVmax, 16.82) was noted, while an area of the radiopharmaceutic accumulation was detected in the body of the L2 vertebra and sigmoid colon. Radical mastectomy was performed In early December 2022. The tumor size was 5.3 cm, the resection margin was free of tumor cells, metastases were found in 2 of 14 lymph nodes. In order to prevent relapse, AIT was continued: 790 million CIKs were administered during a year. According to MRI data in March 2023, there was no relapse. In August 2024, the lesion in the ileum still remains. The median overall survival of patients with TNBC is 10.2 months. The average life expectancy of patients with metastases is less than 1 year. In the presented clinical case, 34 months have passed since the diagnosis, thus indicating an effective combination of AIT with surgical treatment. We conclude that AIT CIKs has a high potential for treatment of patients with TNBC.

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