Triple-negative breast cancer: treatment challenges and solutions.
Triple-negative breast cancer: treatment challenges and solutions.
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三阴性乳腺癌：治疗挑战和解决方案。
DOI：
10.2147/bctt.s69488
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Jerusalem G
中科院分区：
文献类型：
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作者：
Collignon J;Lousberg L;Schroeder H;Jerusalem G
三阴性乳腺癌（TNBC）定义为缺乏雌激素和孕激素受体以及缺乏HER2过表达。这些癌症代表具有不良预后的异质性乳腺癌亚型。除了使用化疗（CT）外，几乎没有全身性治疗选择。这种疾病的异质性限制了靶向治疗在乳腺癌患者群体中的成功发展。目前，没有批准的TNBC靶向治疗。然而，正在进行深入研究，以确定具体目标，并开发更多更好的全身治疗方案。标准的辅助和新辅助治疗方案包括蒽环类、环磷酰胺和紫杉烷类。基于铂的CT已被提议作为TNBC中感兴趣的另一CT选项。我们回顾了这种治疗的作用，特别是在携带BRCA生殖系突变的患者。关于铂基CT在TNBC中的作用的可用数据主要是在新辅助治疗环境中获得的。现有指南尚未推荐常规使用铂基CT。许多研究已经报道了TNBC的分子表征。已经确定了若干可采取行动的目标。基于在临床前研究中观察到的有希望的结果，新的治疗策略目前正在临床试验中进行测试。这些靶点包括雄激素受体、EGFR、PARP、FGFR和血管生成途径。我们回顾了最近的数据在这一领域的实验药物。我们还讨论了有关免疫检查点抑制剂的最新数据。
Triple-negative breast cancers (TNBCs) are defined by the absence of estrogen and progesterone receptors and the absence of HER2 overexpression. These cancers represent a heterogeneous breast cancer subtype with a poor prognosis. Few systemic treatment options exist besides the use of chemotherapy (CT). The heterogeneity of the disease has limited the successful development of targeted therapy in unselected patient populations. Currently, there are no approved targeted therapies for TNBC. However, intense research is ongoing to identify specific targets and develop additional and better systemic treatment options. Standard adjuvant and neoadjuvant regimens include anthracyclines, cyclophosphamide, and taxanes. Platinum-based CT has been proposed as another CT option of interest in TNBC. We review the role of this therapy in general, and particularly in patients carrying BRCA germ-line mutations. Available data concerning the role of platinum-based CT in TNBC were acquired primarily in the neoadjuvant setting. The routine use of platinum-based CT is not yet recommended by available guidelines. Many studies have reported the molecular characterization of TNBCs. Several actionable targets have been identified. Novel therapeutic strategies are currently being tested in clinical trials based on promising results observed in preclinical studies. These targets include androgen receptor, EGFR, PARP, FGFR, and the angiogenic pathway. We review the recent data on experimental drugs in this field. We also discuss the recent data concerning immunologic checkpoint inhibitors.