中国癌症杂志 ›› 2022, Vol. 32 ›› Issue (8): 669-679.doi: 10.19401/j.cnki.1007-3639.2022.08.001

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三阴性乳腺癌精准治疗研究的新进展与未来展望

肖玉铃()(), 朱秀之, 江一舟, 邵志敏()()   

  1. 复旦大学附属肿瘤医院乳腺外科/复旦大学乳腺癌研究所,复旦大学上海医学院肿瘤学系,上海 200032
  • 收稿日期:2022-06-20 修回日期:2022-07-10 出版日期:2022-08-30 发布日期:2022-09-19
  • 通信作者: 邵志敏 E-mail:16307130351@fudan.edu.cn;zhimingshao@fudan.edu.cn
  • 作者简介:肖玉铃(ORCID:0000-0002-3684-0816),复旦大学附属肿瘤医院博士研究生,E-mail: 16307130351@fudan.edu.cn
    邵志敏,主任医师,教授,首批教育部长江学者特聘教授,国家杰出青年科学基金项目获得者,复旦大学特聘教授。现任复旦大学肿瘤研究所所长、乳腺癌研究所所长,大外科主任兼乳腺外科主任,曾任中国抗癌协会乳腺癌专业委员会主任委员,中国抗癌协会靶向治疗专业委员会主任委员,中华医学会肿瘤学分会副主任委员,第八届亚洲乳腺癌协会主席,St.Gallen乳腺癌大会专家团成员。主要从事乳腺癌的临床和基础研究,建立适合中国人群的早期筛查和诊疗流程,确立三阴性乳腺癌“复旦分型”和精准治疗策略,开展临床试验改善患者预后。已在Cancer CellCell MetabolismCell ResearchJournal of Clinical OncologyJAMA OncologyJournal of the National Cancer Institute等重要期刊上发表论著500余篇,被引用逾8 000次,主编专著10部。多次获得国家科技进步二等奖,教育部科技进步一、二等奖,卫健委科技进步一等奖,上海市科技进步一、二、三等奖,领衔团队入选教育部创新团队。先后主持国家自然科学基金重大项目、十五攻关课题,卫生部临床重点项目等国家级及省部级项目50余项。

New research advances and future prospect in precision treatment of triple-negative breast cancer

XIAO Yuling()(), ZHU Xiuzhi, JIANG Yizhou, SHAO Zhimin()()   

  1. Department of Breast Surgery, Fudan University Shanghai Cancer Center/Fudan University Breast Cancer Institute, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Received:2022-06-20 Revised:2022-07-10 Published:2022-08-30 Online:2022-09-19
  • Contact: SHAO Zhimin E-mail:16307130351@fudan.edu.cn;zhimingshao@fudan.edu.cn

摘要:

世界卫生组织国际癌症研究机构最新发布的数据显示,乳腺癌现已取代肺癌成为全球发病率最高的恶性肿瘤。三阴性乳腺癌(triple-negative breast cancer,TNBC)是雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达均为阴性的乳腺癌,与其他分子分型的乳腺癌相比,TNBC具有易复发转移、整体预后差等特点。TNBC对内分泌治疗及抗HER2治疗不敏感,化疗是其主要的系统治疗手段。随着基因组学、转录组学、代谢组学、蛋白组学、微生物组学的蓬勃发展及对TNBC分子分型的深入研究,针对不同靶点的靶向治疗药物和针对免疫检查点的免疫治疗药物的出现,如多聚腺苷二磷酸核糖聚合酶[poly(ADP-ribose) polymerase,PARP]抑制剂、人滋养细胞表面抗原2(trophoblast cell-surface antigen 2,TROP-2)抗体药物偶联物、pembrolizumab、atezolizumab、durvalumab等,已为TNBC的治疗提供新的手段,正在改变TNBC的临床实践。“精准治疗”“分类而治”是未来发展的方向。本文以TNBC的分子分型为基础,对其靶向治疗和免疫治疗研究的新进展进行归纳总结,以期为今后TNBC精准治疗策略提供参考。

关键词: 三阴性乳腺癌, 分子分型, 精准治疗, 靶向治疗, 免疫治疗

Abstract:

According to the latest data released by the Cancer Research Institute of the World Health Organization, breast cancer has replaced lung cancer as the malignant tumor with the highest incidence rate in the world. Triple-negative breast cancer (TNBC) is defined by a lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Compared with other types of breast cancer, TNBC bears the characteristics of high metastasis rate, strong invasiveness and poor prognosis. TNBC is not sensitive to endocrine therapy and anti-HER2 therapy, and chemotherapy is its main systemic treatment. With the vigorous development of genomics, transcriptomics, metabolomics, proteomics, microbiomics technologies and the in-depth study of TNBC molecular subtyping, targeted therapy and immunotherapy drugs, including poly(ADP-ribose) polymerase (PARP) inhibitors, trophoblast cell-surface antigen 2 (TROP-2) antibody-drug conjugate, pembrolizumab, atezolizumab, durvalumab, etc., have provided new therapeutic methods, which are changing the clinical practice and treatment pattern of TNBC. It is believed accurate therapy will become a new direction of development in the future. Based on the molecular subtypes of TNBC, here we summarized the research advances in targeted therapy and immunotherapy of TNBC, in order to provide reference for the precise treatment strategy of TNBC in the future.

Key words: Triple-negative breast cancer, Molecular subtypes, Precision therapy, Targeted therapy, Immunotherapy

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