2022年改变晚期乳腺癌临床实践的重要研究

doi:10.19401/j.cnki.1007-3639.2023.02.003

中国癌症杂志 ›› 2023, Vol. 33 ›› Issue (2): 110-116.doi: 10.19401/j.cnki.1007-3639.2023.02.003

2022年改变晚期乳腺癌临床实践的重要研究

张会强(), 江泽飞()

解放军总医院第五医学中心肿瘤医学部，北京 100071

收稿日期:2022-12-30 修回日期:2023-01-31 出版日期:2023-02-28 发布日期:2023-03-22
通信作者: 江泽飞（ORCID: 0000-0002-4295-0173），主任医师，教授，博士研究生导师，解放军总医院第五医学中心肿瘤医学部副主任。
作者简介:张会强（ORCID: 0000-0002-8039-6169），硕士，主治医师。
江泽飞，主任医师，教授，博士研究生导师。现任解放军总医院第五医学中心肿瘤医学部副主任，担任中国临床肿瘤学会（Chinese Society of Clinical Oncology，CSCO）副理事长兼秘书长，北京医学会乳腺疾病分会主任委员，St. Gallen国际乳腺癌诊疗共识专家团成员。担任中央军委保健专家和中央会诊专家，国家药品管理局新药审评专家。先后承担多项国家科技专项、国家自然科学基金、军队科研项目和北京市科研课题。牵头完成多项国内、国际多中心临床研究。近5年发表论著70余篇。

Key clinical studies on changing clinical practice of advanced breast cancer in 2022

ZHANG Huiqiang(), JIANG Zefei()

Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100071, China

Received:2022-12-30 Revised:2023-01-31 Published:2023-02-28 Online:2023-03-22
Contact: JIANG Zefei

摘要/Abstract

摘要：

随着乳腺癌综合治疗水平的提高和抗肿瘤药物的不断发展，晚期乳腺癌患者的生存情况有了明显改善。乳腺癌进入精细分类、精确分层的新阶段，2022年晚期乳腺癌研究领域取得了多项突破性进展，各亚型治疗有了新的变化，研究结果影响诊疗指南，改变临床实践。激素受体阳性晚期乳腺癌的研究重点在于细胞周期蛋白依赖性激酶4和6（cyclin-dependent kinase 4 and 6，CDK4/6）抑制剂治疗失败患者的治疗。人表皮生长因子受体2（human epidermal growth factor receptor 2，HER2）阳性晚期乳腺癌的治疗中新型抗HER2的抗体药物偶联物（antibody-drug conjugate，ADC）成为研究热点。晚期三阴性乳腺癌（triple-negative breast cancer，TNBC）中免疫治疗需要更多的研究证据，靶向Trop-2的ADC取得了一定疗效。HER2低表达晚期乳腺癌属于特定人群，ADC治疗正在改变临床实践模式。本文对2022年度不同类型晚期乳腺癌的研究进展进行总结，以期更好地指导晚期乳腺癌的治疗，改善患者预后。

关键词: 晚期乳腺癌, 临床研究, 研究进展

Abstract:

With the improvement of comprehensive treatment of breast cancer and the continuous development of anti-tumor drugs, the survival time of breast cancer patients, especially advanced breast cancer, has been further extended. In recent years, the treatment of advanced breast cancer has ushered an era of fine classification and precise tiered therapy. In 2022, many breakthroughs have been made in the field of advanced breast cancer research. With changes in the treatment of each subtype, some treatment schemes affecting clinical practice have been incorporated into treatment guidelines. The treatment for hormone-receptor-positive advanced breast cancer focuses on patients who have failed treatment with cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors. Novel anti-human epidermal growth factor receptor 2 (HER2) antibody-drug conjugates (ADC) in advanced HER2 positive breast cancer are the focus of research. More research evidence is needed for immunotherapy in advanced triple-negative breast cancer (TNBC), and the treatment with ADC targeting Trop-2 has been effective. Treatment with ADC in HER2-low breast cancer are changing clinical practice. In this article, we summarized the research progress of different types of advanced breast cancer in this year, in order to better guide the individualized treatment and improve the prognosis of advanced breast cancer patients.

Key words: Advanced breast cancer, Clinical study, Research progress

中图分类号:

R737.9

张会强, 江泽飞. 2022年改变晚期乳腺癌临床实践的重要研究[J]. 中国癌症杂志, 2023, 33(2): 110-116.

ZHANG Huiqiang, JIANG Zefei. Key clinical studies on changing clinical practice of advanced breast cancer in 2022[J]. China Oncology, 2023, 33(2): 110-116.

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参考文献 23

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Stratifications	Level 1 recommendations	Level 2 recommendations	Level 3 recommendations
Endocrine therapy-naive	① AI + abemaciclib (1A); ② AI + palbociclib (1B)	① AI (1A); ② Fulvestrant (2A); ③ Fulvestrant + CDK4/6 inhibitor (2A)	TAM (2B)
Failure to TAM	① AI + Abemaciclib (1A); ② AI + HDAC inhibitor (1A); ③ AI + palbociclib (1B)	① AI (2A); ② Fulvestrant (2A); ③ Fulvestrant + CDK4/6 inhibitor (1B)
Failure to NSAI	① Fulvestrant + abemaciclib (1A); ② SAI + HDAC inhibitor (2A); ③ Fulvestrant + dalpiciclib (2A); ④ Fulvestran + palbociclib (1B)	① SAI + CDK4/6 inhibitor (2A); ② SAI + everolimus (1B); ③ Fulvestrant (2A)	① SAI (2B); ② Fulvestrant + SAI (2B); ③ TAM or toremifene (2B); ④ Progestin (2B)
Failure to SAI	① Fulvestrant + abemaciclib (1A); ② Fulvestrant + dalpiciclib (2A); ③ Fulvestrant + palbociclib (1B)	① Fulvestrant (2A); ② NSAI + CDK4/6 inhibitor (2A)	① NSAI (2B); ② TAM or toremifene (2B); ③ Progestin (2B)
Failure to CDK4/6 inhibitor		① HDAC inhibitor + endocrine therapy (2A); ② Another CDK4/6 inhibitor + endocrine therapy (2A); ③ Scientifically designed clinical trials	① Progestin (2B); ② Toremifene (2B)

2022年改变晚期乳腺癌临床实践的重要研究

Key clinical studies on changing clinical practice of advanced breast cancer in 2022

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