Overview of recent advances in metastatic triple negative breast cancer.
Overview of recent advances in metastatic triple negative breast cancer.
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转移性三阴性乳腺癌的最新进展概述。
DOI：
10.5306/wjco.v12.i3.164
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发表时间：
2021-03-24
影响因子：
2.8
通讯作者：
Kelly CM
中科院分区：
文献类型：
--
作者：
O'Reilly D;Sendi MA;Kelly CM
转移性三阴性乳腺癌（TNBC）具有侵袭性表型，偏好内脏器官和大脑。对化疗的最佳反应主要在一线。最近的研究表明，atezolizumab/pembrolizumab联合化疗可改善程序性死亡配体1阳性转移性TNBC的无进展生存期。然而，最近在类似人群中进行的一项试验显示，atezoli-zumab和紫杉醇没有任何益处，这导致了食品和药物管理局的警告。两项III期试验（OLYMPIAD和BROCADE 3）证明了分别接受奥拉帕尼或Talazoparib治疗的BRCA相关转移性TNBC患者的无进展生存期（PFS）获益，但总生存期无获益。对于接受Talazoparib治疗的患者，与化疗相比，健康相关生活质量恶化的时间也更长。BROCADE 3试验表明，铂和维利帕尼的组合增加了一线转移性TNBC的PFS，但以增加毒性为代价。没有聚（腺苷二磷酸-核糖）聚合酶抑制剂（PARPi）和铂的头对头比较。关于铂类药物治疗后PARPi维持治疗作为BRCA相关卵巢癌标准治疗的作用，仍有未解答的问题。其他治疗领域包括靶向磷酸肌醇3-激酶途径、蛋白激酶B、雷帕霉素的哺乳动物靶标中的畸变或利用抗体药物缀合物。本文综述了转移性TNBC的最新和新兴治疗选择。我们检索了PubMed、clinicaltrials.gov和最近的美国临床肿瘤学会、圣安东尼奥乳腺癌会议和欧洲医学肿瘤学会的国际会议。
Metastatic triple negative breast cancer (TNBC) has an aggressive phenotype with a predilection for visceral organs and brain. Best responses to chemotherapy are predominately in the first line. Recent studies have demonstrated improved progression free survival with the combination of atezolizumab/pembrolizumab and chemotherapy in programmed death-ligand 1 positive metastatic TNBC. However, a recent trial in a similar population showed no benefit for atezoli-zumab and paclitaxel which led to a Food and Drug Administration alert. Two phase III trials (OLYMPIAD and BROCADE3) demonstrated a benefit in progression free survival (PFS) but not overall survival in patients with BRCA-associated metastatic TNBC treated with Olaparib or Talazoparib respectively. For those treated with Talazoparib, the time to deterioration in health related-quality of life was also longer compared to chemotherapy. The BROCADE3 trial demonstrated that the combination of a platinum and veliparib increased PFS in first-line metastatic TNBC but at the cost of increased toxicity. There are no head-to-head comparisons of a poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPi) and platinums. There are unanswered questions regarding the role of PARPi maintenance after platinum therapy as is standard of care in BRCA-associated ovarian cancer. Other areas of therapeutic interest include targeting aberrations in the phosphoinositide 3-kinase pathway, protein kinase B, mammalian target of rapamycin or utilising antibody drug conjugates. This review focusses on recent and emerging therapeutic options in metastatic TNBC. We searched PubMed, clinicaltrials.gov and recent international meetings from American Society of Clinical Oncology, San Antonio Breast Cancer Conference and the European Society of Medical Oncology.