化疗联合PD-(L)1单抗治疗晚期三阴性乳腺癌的研究进展  

Research progress of chemotherapy combined with anti-PD-(L)1 treatment in advanced triple-negative breast cancer

作　　者：刘佳静 黄桂春 王文艺 顾军[1,3] LIU Jiajing;HUANG Guichun;WANG Wenyi;GU Jun(Department of General Surgery,Jinling Hospital of Nanjing Medical University,Jiangsu Nanjing 210002,China;Department of Medical Oncology,,Jinling Hospital Affiliated to Medical School of Nanjing University,Jiangsu Nanjing 210002,China;Department of General Surgery,Jinling Hospital Affiliated to Medical School of Nanjing University,Jiangsu Nanjing 210002,China)

机构地区：[1]南京医科大学附属金陵医院普通外科,江苏南京210002 [2]南京大学医学院附属金陵医院肿瘤科,江苏南京210002 [3]南京大学医学院附属金陵医院普通外科,江苏南京210002

出　　处：《现代肿瘤医学》2023年第6期1156-1161,共6页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:81472668);江苏省青年医学重点人才项目(编号:QNRC2016887)。

摘　　要：乳腺癌是目前国内女性发病率最高的恶性肿瘤,其中15%~20%为三阴性乳腺癌(triple nega-tive breast cancer,TNBC)。乳腺癌整体预后较好,但TNBC恶性程度高、治疗手段少,导致晚期TNBC患者临床预后较差。随着近几年免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)的问世,免疫治疗[主要是PD-(L)1单抗]成为TNBC患者可选择的一种治疗方式。然而PD-(L)1单抗单药治疗TNBC有效率不高,化疗联合PD-(L)1单抗能给TNBC患者带来更好的反应率和预后。化疗与PD-(L)1单抗的协同作用机制目前尚不明确,限制了化疗联合PD-(L)1单抗在TNBC中的应用。本文分别总结了化疗对肿瘤免疫微环境的调控和PD-(L)1单抗对肿瘤免疫微环境的调控,并特别从微生物组、肿瘤代谢等方面综述了化疗与PD-(L)1单抗交互作用在晚期TNBC治疗中的研究进展,以期为进一步提高化疗联合PD-(L)1单抗在TNBC中的疗效提供参考。Breast cancer is currently the highest incidence of female malignancy in China, of which 15%~20% are triple-negative breast cancer(TNBC).The overall prognosis of breast cancer is good, but the degree of TNBC malignancy is high, and the treatment methods are few, resulting in a poor clinical prognosis in patients with advanced TNBC.With the advent of immune checkpoint inhibitors(ICIs) in recent years, immunotherapy [mainly PD-(L)1 monoclonal antibody]has become an alternative treatment for patients with TNBC.Current clinical data show that PD-(L)1 monoclonal antibody monotherapy in TNBC is not efficient while chemotherapy combined with PD-(L)1 monoclonal antibody can bring better response rates and prognosis to TNBC patients.The synergistic mechanism of chemotherapy with PD-(L)1 monoclonal antibody is currently unclear, limiting the use of chemotherapy combined with PD-(L)1 monoclonal antibody in TNBC.In this paper, the research progress of chemotherapy combined with PD-(L)1 monoclonal antibody in advanced TNBC is reviewed from three perspectives: Effects of chemotherapy on tumor immune microenvironment, effects of PD-(L)1 monoclonal antibody on tumor immune microenvironment, and the interaction of chemotherapy and PD-(L)1 monoclonal antibody, respectively.This review could provide a reference for further improving the efficacy of chemotherapy plus PD-(L)1 monoclonal antibody in TNBC.

关 键 词：三阴性乳腺癌 化疗 免疫检查点抑制剂 肿瘤微环境 肿瘤免疫 

分 类 号：R737.9[医药卫生—肿瘤]