INSUFFICIENCY OF IMMUNOTHERAPY IN MUCINOUS CANCERS.

Interesting this case in point by Baretta et al. published in Clinical Breast Cancer:

"RESISTANCE TO TRASTUZUMAB IN HER-2 POSITIVE MUCINOUS INVASIVE DUCTAL BREAST CARCINOMA"
BRAVO! For addressing this topic.  Yes indeed, while it is obvious that if a tumor is Her-2 positive it would more likely respond to Herceptin, their 2 cases demonstrate the power of Mucin into shielding these receptors from their Agonist Herceptin.   They specify that to be consider Mucinous, the tumor should have a greater than 50% Mucinous component (you figure it out or just wait for the pathologist to call it).  the other component is "ductal" of course.  And as a matter of proportion, a "Mixed" type could be defined!
And yes the authors believed that "Mucin acted as a barrier against Trastuzumab".  They went on to comment that "Mucins has a central role in maintaining homeostasis and protecting the luminal surfaces of epithelium-lined ducts in the human body."  They went on to conclude that appreciating the peculiarity of Mucin presence should allow a early change in therapy!  And Bravo again to the team!

Several other aspect of immunothereapy were discussed by RUDY, a fellow in Oncology,
She suggested in a comprehensive review that infiltration of the lymphocyte in the tumor was a good prognosis (our pathologists need to report this to us) and the bad role of TWIST gene,
"  Twist was a tumor-associated antigen recognized by tumor-specific CD8⁺ T cells; thus, this study provided a rationale for further exploration of immunotherapy using the pTw9 epitope. Additional animal studies must be done before human studies to determine the value of targeting Twist in the adjuvant setting may begin. Investigators hope to find out whether targeting Twist may prevent gross metastasis of breast cancer in patients with Twist-positive micrometastatic disease."  RUDY ET AL