Triple-negative breast cancer
Triple-negative breast cancer
复制标题
DOI：
10.1007/s10354-010-0773-6
复制
发表时间：
2010-04-01
影响因子：
0.9
通讯作者：
Steger, Guenther G.
中科院分区：
文献类型：
--
作者：
Bartsch, Rupert;Ziebermayr, Reinhard;Steger, Guenther G.
乳腺癌生物学特性的最新进展最终增加了我们对潜在肿瘤生物学的理解。虽然对于内分泌反应性疾病和Her2阳性疾病有不同的分子靶向治疗，但到目前为止还没有针对三阴性乳腺癌的特异性靶向治疗方法。临床前和有限的临床数据表明，以铂为基础的方案可能是最有效的传统化疗方案，但缺乏前瞻性随机试验。贝伐单抗和其他针对肿瘤血管生长的药物在所有亚型的乳腺癌中都具有潜在的活性，因此不被认为是仅针对三阴性肿瘤的靶向治疗方法。由于DNA损伤修复的特定缺陷，基底样癌依赖于替代的、更容易出错的修复途径。目前，科学兴趣主要集中在阻断这些机制的药物上。即使在一个相对较小的II期研究中，发现PARP-1抑制剂与铂衍生物联合使用也比单独化疗显示出显著的生存益处。这是第一次，这种方法提供了对三阴性疾病进行高活性、特异性治疗的机会。
Recent advances in biological characterization of breast cancer have eventually increased our understanding of underlying tumour biology. While for endocrine responsive and Her2-positive disease different molecular targeted therapies are available, up to now no specific targeted approach for triple-negative breast cancer has been developed.Patients with triple-negative disease are at high risk for tumour recurrence. Preclinical and limited clinical data suggest that platinum-based regimens may be the most active conventional chemotherapy, but prospective randomized trials are missing. Bevacizumab and other agents targeting tumour vessel growth have potential activity in all subtypes of breast cancer, and therefore are not considered a targeted approach for triple-negative tumours alone.Due to specific defects in DNA-damage repair, basal-like cancers depend on alternative, more error-prone repair pathways. Currently, scientific interest is focussing on drugs blocking those mechanisms. PARP-1 inhibitors, in conjunction with platinum derivatives, were found to exhibit significant survival benefit over chemotherapy alone even in a relatively small phase II study. For the first time, this approach offers the chance of highly active, specific therapy for triple-negative disease.