老年三阴性乳腺癌患者的临床困境和系统治疗策略

陈君瑶; 张文涛; 刘巧; 聂建云

doi:10.19401/j.cnki.1007-3639.2023.05.011

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老年三阴性乳腺癌患者的临床困境和系统治疗策略

综述 | 更新时间：2025-12-31

- 老年三阴性乳腺癌患者的临床困境和系统治疗策略
- Clinical dilemma and systemic treatment strategy of triple-negative breast cancer in the elderly
- 中国癌症杂志 2023年33卷第5期页码：506-516
- 作者机构：
  
  1. 昆明医科大学临床肿瘤学院，云南昆明 650000
  2. 云南省肿瘤医院（昆明医科大学第三附属医院）乳腺外科，云南昆明 650000
- 作者简介：
  
  [ "陈君瑶（ORCID: 0000-0002-8096-3936），硕士在读，住院医师。" ]
  聂建云（ORCID: 0000-0003-3691-8940），博士，主任医师，云南省肿瘤医院（昆明医科大学第三附属医院）副院长。
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2023.05.011
  中图分类号： R737.9
- 收稿：2022-09-02，
  
  修回：2022-11-23，
  
  纸质出版：2023-05-30
- 稿件说明：
移动端阅览
陈君瑶, 张文涛, 刘巧, 等. 老年三阴性乳腺癌患者的临床困境和系统治疗策略[J]. 中国癌症杂志, 2023,33(5):506-516.

Junyao CHEN, Wentao ZHANG, Qiao LIU, et al. Clinical dilemma and systemic treatment strategy of triple-negative breast cancer in the elderly[J]. China Oncology, 2023, 33(5): 506-516.
陈君瑶, 张文涛, 刘巧, 等. 老年三阴性乳腺癌患者的临床困境和系统治疗策略[J]. 中国癌症杂志, 2023,33(5):506-516. DOI： 10.19401/j.cnki.1007-3639.2023.05.011.

Junyao CHEN, Wentao ZHANG, Qiao LIU, et al. Clinical dilemma and systemic treatment strategy of triple-negative breast cancer in the elderly[J]. China Oncology, 2023, 33(5): 506-516. DOI： 10.19401/j.cnki.1007-3639.2023.05.011.

摘要

三阴性乳腺癌（triple-negative breast cancer，TNBC）缺乏明确的生物标志物，现有治疗手段以化疗为主，疗效有限且不良反应大。10% ~ 21%的TNBC为老年患者，多伴随心、脑、肾疾病等诸多慢性合并症，对化疗耐受性差，是临床诊疗实践的一大难题。同时，专门针对老年TNBC患者的临床研究较少，导致这部分患者的安全及合理用药缺乏充足的循证医学证据，在疾病诊疗方面存在很多难点和争议。此外，老年TNBC有其特征，非肿瘤因素所致死亡率较高。因此，患者生存获益与生活质量及耐受性之间的平衡尤为重要。本文主要针对老年TNBC的流行病学、疾病生物学行为及特征、诊疗现状及未被满足的治疗需求等进行总结分析，并初步探索新型抗体药物偶联物（antibody-drug conjugate，ADC）在老年TNBC中的获益，以期为老年TNBC系统治疗策略的选择提供参考。

Abstract

There is no specific biomarker for triple-negative breast cancer (TNBC)

and chemotherapy remains as backbone but with limited efficacy and more side effects. 10%-21% TNBC are elderly patients with high prevalence of concomitant cardio-cerebrovascular and renal complications

which may lead to intolerance of chemotherapy. How to properly treat these elderly TNBC patients becomes a big challenge during daily clinical practice. To date

few clinical trials specifically focus on elderly TNBC patients

thus no enough evidence-based safety and efficacy data are provided to support the proper therapy to this population. There are also challenges and controversies in the diagnosis and treatment. Elderly TNBC patients have special age-related disease characteristics and high non-cancer related mortality. Therefore

it is very important to balance survival benefit and quality of life during the treatment. This paper summarized data of the epidemiology

tumor biological behavior

current diagnosis and treatment status and the huge unmet medical needs of elderly TNBC patients

and explored the benefits of novel antibody-drug conjugate (ADC)

to provide certain guidance on systemic treatment strategies for elderly TNBC patients.

关键词

Keywords

references

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