三阴性乳腺癌基因学分子分型和个体化治疗新进展  

Current advances of genotype classification and individualized treatment in triple negative breast cancer

作　　者：郑红梅[1] 李祥[1] 金立亭[1] 袁峰[1] 庄莹[1] 吴新红[1] 

机构地区：[1]湖北省肿瘤医院乳腺外科.湖北省乳腺病防治研究中心,湖北武汉430079

出　　处：《中华肿瘤防治杂志》2016年第17期1198-1204,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：湖北省卫生计生委重点科研项目(WJ2015MA016)

摘　　要：目的三阴性乳腺癌(triple negative breast cancer,TNBC)作为乳腺癌的一种特殊类型,具有高侵袭性,极易出现局部复发和远处转移。近年来关于TNBC进一步亚分类,并且针对各亚型进行相应靶向治疗的基础研究和临床研究均较多。本研究对国内外TNBC的分子分型和个体化治疗新进展进行综述分析。对国内外三阴性乳腺癌(triple negative breast cancer,TNBC)的分子分型以及个体化治疗新进展进行综述分析。方法应用PubMed及CNKI期刊全文数据库检索系统,以"三阴性乳腺癌、TNBC、分子分型、治疗"等为关键词,检索2011-01-2016-05相关文献,共检索到英文文献240条,中文文献449条。纳入标准:(1)TNBC的生物学功能;(2)TNBC的分子分型;(3)TNBC的个体化治疗。剔除标准:(1)乳腺癌的分子分型;(2)乳腺癌的个体化治疗。根据剔除标准剔除中文文献130条,英文文献141条,最后纳入分析63篇文献。结果 TNBC从基因学角度分为6个亚型,针对每个亚型均有不同的个体化治疗靶向药物,包括表皮生长因子受体(epidermal growth factor receptor,EGFR)抑制剂、铂类、聚腺苷酸二磷酸核糖转移酶(poly-AD-ribose polymerase,PARP)抑制剂、蒽环/紫衫、免疫治疗、血管内皮生长因子受体(vascular endothelial growth factor receptor,VEGFR)抑制剂、雄激素受体(androgen receptor,AR)拮抗剂以及各靶向治疗手段的联合使用。结论 TNBC是异质性疾病,其分子分型的确定对于理解肿瘤的生物学特征和临床行为,以及发展TNBC个体化治疗都是必需的。由于TNBC肿瘤信号通路之间的交联,发展不同靶向药物的联合应用才有望真正的提高该疾病的总生存。OBJECTIVETriple negative breast cancer（TNBC）as a particular subtype of breast cancer, was exteremly invasive with high rate of local recurrence and distant metastasis. The basic and clinical researches on classification of TN- BC and corresponding personalized treatment is vast. Here we summarize the current advances of genotype classification and individualized treatment in triple negative breast cancer （TNBC）. METHODS The papers of literature were located through electronic searches of the PubMed and CNKI database （from January 2011 to May 2016） with the key words ＂tri- ple negative breast cancer, TNBC, classification, treatment＂. A total of 240 English articles and 229 Chinese articles were found. With the inclusion criteria： （1） the molecular trait of TNBC; （2） genotype classification of TNBC; （3） the individualized treatment of TNBC and exclusion criteria： （1） classification of breast cancer; （2） individualized treatment of breast cancer, a total of 63 related articles were chosen finally. RESULTS TNEC is a heterogeneous disease composed of 6 distinct molecular subtypes, each with a unique biology that responds differentially to current therapies including epidermal growth factor receptor （EGFR） inhibitor, platinum, poly-AD-ribose polymerase （PARP） inhibitor, anthracycline/paclitaxel, immunotherapy, vascular endothelial growth factor receptor （VEGFR） inhibitor, androgen receptor （AR） inhibitor and the combi- nation of different targeted thepapies. CONCLUSIONS TNBC is clearly a complex disease. The identification of molecular sub- types is essential for understanding the biologic characteristics and clinical behaviors of TNBC as well as for developing personal- ized treatments. Because of cross-talk between pathways, which may be especially relevant in TNBC, it is likely that combinations of targeted agents ultimately will be required to optimally treat the disease.

关 键 词：三阴性乳腺癌 分子分型 治疗 综述文献 

分 类 号：R737.9[医药卫生—肿瘤]