|
三阴性乳腺癌的治疗研究进展
|
Abstract:
世界卫生组织国际癌症研究机构的数据显示,乳腺癌现已成为全球发病率最高的恶性肿瘤。三阴性乳腺癌是一种ER、PR和Her-2均未表达的乳腺癌,占乳腺癌病例的10%~20%,具有发病年龄早、侵袭度高及早期易复发等特征,分析病因尚未明确,可能与遗传、作息及饮食等因素有关。相较于其他亚型,三阴性乳腺癌的治疗面临更大的挑战,因为常规的激素治疗和靶向治疗并不适用。本综述将探讨三阴性乳腺癌目前的治疗方式,涵盖手术、放疗、化疗、免疫疗法以及新兴的靶向治疗、中药治疗。
The International Agency for Research on Cancer says that breast cancer is now the world’s leading cancer. TNBC is a subtype of breast cancer, which does not express ER, PR and HER-2, accounting for 10%~20% of breast cancer cases, identified characteristics of this disease include early age of onset, highly invasive nature and easy recurrence in the early stages. The cause of the disease has not been clearly analysed, and it may be related to factors such as heredity, work and rest, and diet. Compared with other subtypes, the treatment of triple-negative breast cancer is more challenging, as conventional hormonal and targeted therapies are not applicable. This review will explore the current treatment modalities for triple-negative breast cancer, covering surgery, radiotherapy, chemotherapy, immunotherapy, as well as emerging targeted therapies, traditional Chinese medicine.
[1] | Siegel, R.L., Miller, K.D., Wagle, N.S. and Jemal, A. (2023) Cancer Statistics, 2023. CA: A Cancer Journal for Clinicians, 73, 17-48. https://doi.org/10.3322/caac.21763 |
[2] | Lehmann, B.D., et al. (2011) Identification of Human Triple-Negative Breast Cancer Subtypes and Preclinical Models for Selection of Targeted Therapies. Journal of Clinical Investigation, 121, 2750-2767. https://doi.org/10.1172/JCI45014 |
[3] | Jiang, Y.Z., Ma, D., Suo, C., et al. (2019) Genomic and Transcriptomic Landscape of Triple-Negative Breast Cancers: Subtypes and Treatment Strategies. Cancer Cell, 35, 428-440.E5. |
[4] | 段懿珊, 郝凯峰. 早期三阴性乳腺癌保乳手术治疗的临床效果[J]. 深圳中西医结合杂志, 2023, 33(11): 91-94. |
[5] | Untch, M., Jackisch, C., Schnesswei, A., et al. (2015) A Randomized Phase Ⅲ Trial Comparing Neoadjuvant Chemotherapy with Weekly Nanoparticle-Based Paclitaxel with Solvent-Based Paclitaxel Followed by Anthracyline/Cyclophosphamide for Patients with Early Breast Cancer (GeparSepto); GBG 69. Cancer Research, 75, S2-07. https://doi.org/10.1158/1538-7445.SABCS14-S2-07 |
[6] | 曹志宇, 张庆军, 吴有军, 等. 早期三阴性乳腺癌保乳手术治疗的临床效果[J]. 解放军医学杂志, 2020, 45(9): 986-989. |
[7] | 翟睿, 齐晶, 马晓霞. 三阴性乳腺癌患者采取保乳手术治疗的临床效果及5年随访观察分析[J]. 河北医学, 2023, 29(10): 1677-1682. |
[8] | Offersen, B.V., Alsner, J., Nielsen, H.M., et al. (2020) Hypofractionated versus Standard Fractionated Radiotherapy in Patients with Early Breast Cancer or Ductal Carcinoma in Situ in a Randomized Phase Ⅲ Trial: The DBCG HYPO Trial. Journal of Clinical Oncology, 38, 3615-3625. https://doi.org/10.1200/JCO.20.01363 |
[9] | Kundranda, M.N. and Niu, J. (2015) Albumin-Bound Paclitaxel in Solid Tumors: Clinical Development and Future Directions. Drug Design, Development and Therapy, 9, 3767-3777. https://doi.org/10.2147/DDDT.S88023 |
[10] | Bauer, J.A., et al. (2010) Identification of Markers of Taxane Sensitivity Using Proteomic and Genomic Analyses of Breast Tumors from Patients Receiving Neoadjuvant Paclitaxel and Radiation. Clinical Cancer Research, 16, 681-690. https://doi.org/10.1158/1078-0432.CCR-09-1091 |
[11] | Juul, N., et al. (2010) Assessment of an RNA Interference Screen-Derived Mitotic and Ceramide Pathway Metagene as a Predictor of Response to Neoadjuvant Paclitaxel for Primary Triple-Negative Breast Cancer: A Retrospective Analysis of Five Clinical Trials. The Lancet Oncology, 11, 358-365. https://doi.org/10.1016/S1470-2045(10)70018-8 |
[12] | Trudeau, M., et al. (2005) Selection of Adjuvant Chemotherapy for Treatment of Node-Positive Breast Cancer. The Lancet Oncology, 6, 886-898. https://doi.org/10.1016/S1470-2045(05)70424-1 |
[13] | Henderson, I.C., et al. (2003) Improved Outcomes from Adding Sequential Paclitaxel But Not from Escalating Doxorubicin Dose in an Adjuvant Chemotherapy Regimen for Patients with Node-Positive Primary Breast Cancer. Journal of Clinical Oncology, 21, 976-983. https://doi.org/10.1200/JCO.2003.02.063 |
[14] | Levine, M.N., et al. (2005) Randomized Trial Comparing Cyclophosphamide, Epirubicin, and Fluorouracil with Cyclophosphamide, Methotrexate, and Fluorouracil in Premenopausal Women with Node-Positive Breast Cancer: Update of National Cancer Institute of Canada Clinical Trials Group Trial MA5. Journal of Clinical Oncology, 23, 5166-5170. https://doi.org/10.1200/JCO.2005.09.423 |
[15] | Bonneterre, J., et al. (2005) Epirubicin Increases Long-Term Survival in Adjuvant Chemotherapy of Patients with Poor-Prognosis, Node-Positive, Early Breast Cancer: 10-Year Follow-Up Results of the French Adjuvant Study Group 05 Randomized Trial. Journal of Clinical Oncology, 23, 2686-2693. https://doi.org/10.1200/JCO.2005.05.059 |
[16] | Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of Chemotherapy and Hormonal Therapy for Early Breast Cancer on Recurrence and 15-Year Survival: An Overview of the Randomised Trials. The Lancet, 365, 1687-1717. https://doi.org/10.1016/S0140-6736(05)66544-0 |
[17] | Yin, L., Duan, J.J., Bian, X.W. and Yu, S.C. (2020) Triple-Negative Breast Cancer Molecular Subtyping and Treatment Progress. Breast Cancer Research, 22, Article No. 61. https://doi.org/10.1186/s13058-020-01296-5 |
[18] | 徐硕, 金鹏飞, 徐文峰, 等. 环磷酰胺分析方法的研究进展[J]. 西北药学杂志, 2023, 38(2): 223-226. |
[19] | Nakatsukasa, K., et al. (2017) Docetaxel and Cyclophosphamide as Neoadjuvant Chemotherapy in HER2-Negative Primary Breast Cancer. Breast Cancer, 24, 63-68. https://doi.org/10.1007/s12282-016-0666-7 |
[20] | Wu, C.E., et al. (2014) Identification of Patients with Node-Negative, Triple-Negative Breast Cancer Who Benefit from Adjuvant Cyclophosphamide, Methotrexate, and 5-Fluorouracil Chemotherapy. Anticancer Research, 34, 1301-1306. |
[21] | 康一坤, 袁芃. 《铂类药物晚期乳腺癌应用专家共识(2020版)》解读[J]. 中国肿瘤临床, 2022, 49(6): 271-274. |
[22] | Loibl, S., O’Shaughnessy, J., Untch, M., et al. (2018) Addition of the PARP Inhibitor Veliparib plus Carboplatin or Carboplatin Alone to Standard Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer (BrighTNess): A Randomised, Phase 3 Trial. The Lancet Oncology, 19, 497-509. https://doi.org/10.1016/S1470-2045(18)30111-6 |
[23] | Von Minckwitz, G., et al. (2014) Neoadjuvant Carboplatin in Patients with Triple-Negative and HER2-Positive Early Breast Cancer (GeparSixto; GBG 66): Arandomised Phase 2 Trial. The Lancet Oncology, 15, 747-756. https://doi.org/10.1016/S1470-2045(14)70160-3 |
[24] | Jovanovic, B., et al. (2017) A Randomized Phase II Neoadjuvant Study of Cisplatin, Paclitaxel with or without Everolimus in Patients with Stage II/III Triple-Negative Breast Cancer (TNBC): Responses and Long-Term Outcome Correlated with Increased Frequency of DNA Damage Response Gene Mutations, TNBC Subtype, AR Status, and Ki67. Clinical Cancer Research, 23, 4035-4045. https://doi.org/10.1158/1078-0432.CCR-16-3055 |
[25] | Li, Q., Li, Q., Zhang, P., et al. (2015) A Phase II Study of Capecitabine Plus Cisplatin in Metastatic Triple-Negative Breast Cancer Patients Pretreated with Anthracyclines and Taxanes. Cancer Biology & Therapy, 16, 1746-1753. https://doi.org/10.1080/15384047.2015.1095400 |
[26] | Heeke, A.L. and Tan, A.R. (2021) Checkpoint Inhibitor Therapy for Metastatic Triple-Negative Breast Cancer. Cancer and Metastasis Reviews, 40, 537-547. https://doi.org/10.1007/s10555-021-09972-4 |
[27] | Leon-Ferre, R.A. and Goetz, M.P. (2023) Advances in Systemic Therapies for Triple Negative Breast Cancer. BMJ, 381, e071674. https://doi.org/10.1136/bmj-2022-071674 |
[28] | Zhu, Y., Zhu, X., Tang, C., et al. (2021) Progress and Challenges of Immunotherapy in Triple-Negative Breast Cancer. Biochimica et Biophysica Acta (BBA)—Reviews on Cancer, 1876, Article ID: 188593. https://doi.org/10.1016/j.bbcan.2021.188593 |
[29] | Liu, J., Wang, Y., Tian, Z., et al. (2022) Multicenter Phase II Trial of Camrelizumab Combined with Apatinib and Eribulin in Heavily Pretreated Patients with Advanced Triple-Negative Breast Cancer. Nature Communications, 13, Article No. 3011. https://doi.org/10.1038/s41467-022-30569-0 |
[30] | Peng, Z., Su, P., Yang, Y., et al. (2020) Identification of CTLA-4 Associated with Tumor Microenvironment and Competing Interactions in Triple Negative Breast Cancer by Co-Expression Network Analysis. Journal of Cancer, 11, 6365-6375. https://doi.org/10.7150/jca.46301 |
[31] | Kaewkangsadan, V., Verma, C., Eremin, J.M., et al. (2018) Tumour-Draining Axillary Lymph Nodes in Patients with Large and Locally Advanced Breast Cancers Undergoing Neoadjuvant Chemotherapy (NAC): The Crucial Contribution of Immune Cells (Effector, Regulatory) and Cytokines (Th1, Th2) to Immune-Mediated Tumour Cell Death Induced by NAC. BMC Cancer, 18, Article No. 123. https://doi.org/10.1186/s12885-018-4044-z |
[32] | Bernier, C., et al. (2018) DZ-2384 Has A Superior Preclinical Profile to Taxanes for Thetreatment of Triple-Negative Breast Cancer and Is Synergistic with Anti-CTLA-4 Immunotherapy. Anti-Cancer Drugs, 29, 774-785. https://doi.org/10.1097/CAD.0000000000000653 |
[33] | Nielsen, T.O., et al. (2004) Immunohistochemical and Clinical Characterization of the Basal-Like Subtype of Invasive Breast Carcinoma. Clinical Cancer Research, 10, 5367-5374. https://doi.org/10.1158/1078-0432.CCR-04-0220 |
[34] | Livasy, C.A., et al. (2006) Phenotypic Evaluation of the Basal-Like Subtype of Invasive Breast Carcinoma. Modern Pathology, 19, 264-271. https://doi.org/10.1038/modpathol.3800528 |
[35] | Cho, S.Y. (2019) Identification of ERBB Pathway-Activated Cells in Triple-Negative Breast Cancer. Genomics & Informatics, 17, e3. https://doi.org/10.5808/GI.2019.17.1.e3 |
[36] | Farmer, H., et al. (2005) Targeting the DNA Repair Defect in BRCA Mutant Cells as a Therapeutic Strategy. Nature, 434, 917-921. https://doi.org/10.1038/nature03445 |
[37] | Gelmon, K.A., et al. (2011) Olaparib in Patients with Recurrent High-Grade Serous or Poorly Differentiated Ovarian Carcinoma or Triple-Negative Breast Cancer: A Phase 2, Multicentre, Open-Label, Non-Randomised Study. The Lancet Oncology, 12, 852-861. https://doi.org/10.1016/S1470-2045(11)70214-5 |
[38] | Barton, V.N., et al. (2015) Androgen Receptor Biology in Triple Negative Breast Cancer: A Case for Classification as AR or Quadruple Negative Disease. Hormones and Cancer, 6, 206-213. https://doi.org/10.1007/s12672-015-0232-3 |
[39] | Gucalp, A., et al. (2013) Phase II Trial of Bicalutamide in Patients with Androgen Receptor-Positive, Estrogen Receptor-Negative Metastatic Breast Cancer. Clinical Cancer Research, 19, 5505-5512. https://doi.org/10.1158/1078-0432.CCR-12-3327 |
[40] | 毛丹, 李玲, 胡洋, 等. 中药复方联合化疗治疗IV期三阴性乳腺癌疗效和安全性的系统评价和Meta分析[J]. 中国民族民间医药, 2022, 31(20): 100-108. |