调控肿瘤微环境以克服乳腺癌免疫治疗的耐药OA

While immune checkpoint inhibitors have shown substantial clinical benefits in treating breast cancer,their overall efficacy is limited by resistance mechanisms driven by the tumor microenvironment(TME).Notably,various immunosuppressive cell populations—such as regulatory T cells,tumor-associated macrophages,and myeloid-derived suppressor cells—play a crucial role in fostering therapeutic resistance through multiple pathways.In addition,cancer-associated fibroblasts and the hypoxic conditions characteristic of tumor regions further diminish the effectiveness of immunotherapy.This review offers a comprehensive examination of the latest strategies to modulate the TME and overcome immune resistance.The discussion spans targeted approaches against immunosuppressive cells,metabolic regulation,phototherapy,modulation of tumor immunogenetics,as well as combination therapies and nanoparticle-mediated treatment strategies.Collectively,these developments provide novel theoretical insights and practical avenues for enhancing the overall efficacy of immunotherapeutic interventions in breast cancer.