乳腺癌精准治疗的现状与展望

吴微; 尼露排·阿布都热黑依木; 樊英; 徐兵河

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乳腺癌精准治疗的现状与展望

乳腺癌专刊(2026年) | 更新时间：2026-01-12

- 乳腺癌精准治疗的现状与展望
- 乳腺癌精准治疗的现状与展望
- 中国癌症杂志 2026年
- 作者机构：
  
  国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院肿瘤内科，北京 100021
- 作者简介：
  
  [ "徐兵河，主任医师，教授，博士研究生导师，中国工程院院士。现任国家新药（抗肿瘤）临床研究中心主任，北京协和医学院长聘教授，先进医用材料与医疗器械全国重点实验室主任，乳腺癌创新药物研发与转化研究北京市重点实验室主任，北京肿瘤学会理事长，北京乳腺病防治学会理事长。第一完成人获国家科技进步二等奖、何梁何利基金科技进步奖、全国创新争先奖等多个重要奖项。" ]
- 基金信息：
  
  中央高水平医院临床科研业务费资助（课题编号：2025-LYZX-D-A02）;四大慢病重大专项资助（课题编号:2025ZD0552500）
- DOI：
  中图分类号： R737.9
- 收稿：2026-01-09，
- 稿件说明：
移动端阅览
吴微，尼露排·阿布都热黑依木，樊英, 等. 乳腺癌精准治疗的现状与展望［J］. 中国癌症杂志, 2026, 36.

WU Wei，ABUDUREHEIYIMU Nilupai, FAN Ying, et al. Precision treatment in breast cancer: current advancements and future directions［J］. China Oncol, 2026, 36.
吴微，尼露排·阿布都热黑依木，樊英, 等. 乳腺癌精准治疗的现状与展望［J］. 中国癌症杂志, 2026, 36. DOI：

WU Wei，ABUDUREHEIYIMU Nilupai, FAN Ying, et al. Precision treatment in breast cancer: current advancements and future directions［J］. China Oncol, 2026, 36. DOI：

摘要

乳腺癌精准治疗正从基于分子分型的“分类治疗”阶段，迈向由多层次生物标志物驱动的“个体化全程管理”新纪元。本文系统综述该领域当前治疗格局与未来展望。在HER2阳性乳腺癌领域，以抗体偶联药物（ADCs）和小分子酪氨酸激酶抑制剂（TKI）为代表的药物持续推动治疗革新。尽管疗效显著，复杂的耐药机制仍是核心挑战，未来需依赖新型ADC、双特异性抗体及创新联合策略实现突破。HR阳性/HER2阴性乳腺癌已全面步入“靶向+”时代，CDK4/6抑制剂联合内分泌治疗成为晚期一线标准。针对CDK4/6抑制剂耐药，PI3K/AKT/mTOR通路抑制剂、新型口服选择性雌激素受体下调剂（SERD），以及针对HER2低表达与TROP-2的ADCs，为后线治疗提供了精准且多样的选择。三阴性乳腺癌则因免疫检查点抑制剂（ICIs）及新型抗HER2及TROP-2 ADCs的成功应用，从根本上改变了“无靶可治”的困境。不同机制药物的创新联合策略展现出突破现有治疗限制的潜力，为患者带来新希望。乳腺癌精准治疗将深度融合分子分型细化、液体活检动态监测、人工智能与多组学分析、数字医疗工具及慢性病管理模式，逐步构建覆盖全周期、高度个体化的健康管理体系。通过持续提升创新药物可及性、建设互通共享的数据平台、并深化多学科协作，必将进一步推动精准诊疗实践的优化与普及。

Abstract

Precision treatment in breast cancer is transitioning from a phase of classification-based therapy based on molecular subtypes to a new era of biomarker-driven individualized management. This review systematically summarizes the current advances and future directions in this field. In the realm of HER2-positive breast cancer

antibody–drug conjugates (ADCs) and small-molecule tyrosine kinase inhibitors (TKIs) continue to advance therapeutic innovation. Despite their remarkable efficacy

he complex mechanisms of drug resistance remain a central challenge. Future progress is expected to hinge on novel ADCs

bispecific antibodies

and innovative combination strategies. For HR-positive/HER2-negative breast cancer

treatment has fully entered the “targeted-plus” era

with CDK4/6 inhibitors combined with endocrine therapy established as the first-line standard for advanced disease. To address resistance to CDK4/6 inhibitors

targeted options include inhibitors of the PI3K/AKT/mTOR pathway

novel oral selective estrogen receptor degraders (SERDs)

as well as novel ADCs

offering diverse and precise therapeutic alternatives. Triple-negative breast cancer has moved beyond the “untargetable” dilemma

thanks to the successful introduction of immune checkpoint inhibitors (ICIs) and novel anti-HER2 and TROP-2 ADCs. Innovative combination strategies involving drugs with different mechanisms of action demonstrate the potential to surpass current therapeutic limitations

bringing new hope to patients. Precision medicine in breast cancer is evolving toward a more integrated paradigm that incorporates refined molecular subtyping

dynamic liquid biopsy monitoring

artificial intelligence-enhanced multi-omics analytics

digital health technologies

and chronic disease management frameworks. This convergence will facilitate the establishment of a holistic

highly individualized health management system. Through ongoing improvements in the accessibility of innovative therapeutics

the development of interoperable data platforms

and enhanced multidisciplinary collaboration—collectively accelerating the optimization and broader implementation of precision oncology in clinical practice.

关键词

Keywords

references

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