Therapies for triple negative breast cancer.
Therapies for triple negative breast cancer.
复制标题
三重阴性乳腺癌的疗法。
DOI：
10.1517/14656566.2015.1032246
复制
发表时间：
2015-05
影响因子：
3.2
通讯作者：
McDaid HM
中科院分区：
文献类型：
--
作者：
Andreopoulou E;Schweber SJ;Sparano JA;McDaid HM
三阴性乳腺癌（TNBC）是一种与高复发风险相关的异质性疾病，目前的治疗选择仅限于细胞毒性治疗。生殖系突变可能发生在高达20%的TNBC患者中，这可以作为一种生物标志物，用于识别哪些患者可能患有对铂和/或聚（ADP-核糖）聚合酶抑制剂特别敏感的肿瘤。相当一部分与生殖系BRCA突变无关的TNBC患者可能患有“BRCA样”肿瘤，使这些个体成为类似策略的潜在候选人。这篇综述的目的是强调目前的标准和实验性治疗策略。最近的研究阐明了这种疾病的分子异质性，使其多样化的生物学行为和对化疗的不同反应合理化。现代技术平台提供了可用于治疗干预的分子特征。在癌细胞中通常失调的靶向途径控制细胞过程，例如凋亡、增殖、血管生成、DNA修复、细胞周期进展、免疫调节和侵袭以及转移。新的试验设计和重新定义的终点作为临床结果的替代品，已被引入，以加快突破性疗法的开发，以治疗高风险的早期乳腺癌。
Triple negative breast cancer (TNBC) is a heterogeneous disease associated with a high risk of recurrence, and therapeutic options are currently limited to cytotoxic therapy. Germ-line mutations may occur in up to 20% of unselected patients with TNBC, which may serve as a biomarker identifying which patients may have tumors that are particularly sensitive to platinums and/or inhibitors of poly(ADP-ribose)polymerase. A substantial proportion of patients with TNBCs not associated with germ-line BRCA mutations may have tumors that are ‘BRCA-like’, rendering those individuals potential candidates for similar strategies. The purpose of this review is to highlight the current standard and experimental treatment strategies. Recent research that has illuminated the molecular heterogeneity of the disease rationalizes its diverse biological behavior and differential response to chemotherapy. Modern technology platforms provide molecular signatures that can be mined for therapeatic interventions. Target pathways that are commonly dysregulated in cancer cells control cellular processes such as apoptosis, proliferation, angiogenesis, DNA repair, cell cycle progression, immune modulation and invasion, and metastasis. Novel trial design and re-defined endpoints as surrogates to clinical outcome have been introduced to expedite the development of breakthrough therapies to treat high-risk early-stage breast cancer.