激素受体阳性/人表皮生长因子受体2阳性晚期乳腺癌生物学特点及治疗进展  

Biology characteristics and treatment advancements of HR+/HER2+advanced breast cancer

作　　者：刘德桐 李超[1] 许焱[1] 丁丽[1] 张永强[1,2] Liu Detong;Li Chao;Xu Yan;Ding Li;Zhang Yongqiang(Department of Oncology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Graduate of Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院肿瘤科国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京协和医学院研究生院、中国医学科学院,北京100730

出　　处：《中国医学前沿杂志（电子版）》2024年第4期73-80,共8页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：激素受体阳性(hormone receptor-positive,HR+)/人表皮生长因子受体2阳性(human epidermal growth factor receptor 2-positive,HER2+)晚期乳腺癌是一种异质性较高的肿瘤亚型,各大指南对于HER2+晚期乳腺癌,不论HR阳性或阴性,均建议在抗HER2治疗基础上首选联合化疗,专门针对HR+/HER2+晚期乳腺癌的临床研究不多,其最佳治疗特别是后线治疗选择仍存在争议。晚期乳腺癌很难治愈,兼顾不同治疗手段比如化疗与内分泌治疗的疗效和患者的生活质量等显得非常重要。加之近几年针对HR+的细胞周期蛋白依赖性激酶4/6 (cyclin-dependent kinase 4/6 inhibitor,CDK4/6)抑制剂等靶向药物和针对HER2+乳腺癌的新型抗HER2靶向药物和抗体药物偶联物(antibody-drug conjugate,ADC)的应用,为HR+/HER2+晚期乳腺癌的治疗带来了诸多选择和疗效以及安全性的不确定性。本文综述HR+/HER2+晚期乳腺癌分子生物学和临床病理特点、研究进展和治疗选择,为临床医生治疗决策提供参考。Hormone receptor-positive(HR+)/Human epidermal growth factor receptor 2-positive(HER2+)advanced breast cancer is a tumor subtype characterized with human heterogeneity.For HER2+advanced breast cancer,irrespective of HR positivity or negativity,major guidelines recommend combination with chemotherapy is preferred on the basis of anti-HER2 treatment.There are few clinical studies specifically designed for HR+/HER2+advanced breast cancer and controversies persist regarding the optimal treatment,especially in posterior therapeutic choices.Regardless of the chosen treatment approach,curing advanced breast cancer is challenging.It is very important to balance the efficacy of different treatment modalities such as chemotherapy and endocrine therapy,along with considering the patient's quality of life.In addition,in recent years,the application of targeted drugs,such as Cyclin-dependent kinase 4/6 inhibitor(CDK4/6)inhibitors for HR+and novel anti-HER2 targeted drugs and antibody-drug conjugates(ADC)for HER2-positive breast cancer,brought forth numerous choices,along with uncertainties in efficacy and safety.This article reviews the molecular and clinical-pathological features,research advancements,and treatment options for HR+/HER2+advanced breast cancer,aiming to offer reference for clinicians to make treatment decisions.

关 键 词：晚期乳腺癌 激素受体阳性 人表皮生长因子受体2阳性 生物学特点 治疗进展 

分 类 号：R737.9[医药卫生—肿瘤]