PI3K/AKT/mTOR 信号通路及其靶向治疗在乳腺癌中的应用  

The PI3K/AKT/mTOR signaling pathway and its targeted therapy in breast cancer

作　　者：徐航程 王佳玉 Hangcheng Xu;Jiayu Wang(Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021

出　　处：《中华乳腺病杂志(电子版)》2025年第1期12-19,共8页Chinese Journal of Breast Disease(Electronic Edition)

摘　　要：磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(AKT)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路,简称PAM 信号通路,可通过多种机制影响乳腺癌的发生、发展,并在多种治疗手段耐药中发挥关键作用。 PAM 信号通路异常的乳腺癌患者预后通常较正常者更差。 近年来,针对PAM 信号通路的靶向治疗药物,包括PI3K 抑制剂、AKT 抑制剂、mTOR 抑制剂和PI3K/mTOR 双靶点抑制剂等,在乳腺癌的治疗中取得了较大进展,显著改善了激素受体阳性/HER-2 阴性晚期乳腺癌患者的预后。 本文系统总结了PAM 信号通路抑制剂在不同分子分型乳腺癌中的主要临床研究, 探讨了PAM 信号通路的检测及靶向药物安全性管理的挑战,预测了未来的研究方向。 通过精准检测PAM 信号通路和合理应用相关抑制剂,临床医师可以为乳腺癌患者提供更为优化的治疗方案。The phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway, also known as the PAM signaling pathway, influences breast cancer development and progression through various mechanisms and plays a critical role in therapeutic resistance.Breast cancer patients with aberrant PAM signaling pathway activation typically have worse prognosis compared with those with normal signaling. In recent years, targeted therapies focusing on the PAM signaling pathway,including PI3K inhibitors, AKT inhibitors, mTOR inhibitors and dual PI3K/mTOR inhibitors, have achieved significant progress in breast cancer treatment, particularly in improving the prognosis of hormone receptorpositive, HER-2-negative advanced breast cancer patients. This review systematically summarized key clinical studies on PAM signaling pathway inhibitors across different molecular subtypes of breast cancer, discussed the challenges in PAM pathway detection and safety management of targeted therapy, and predicted future directions in this field. Through precise detection of PAM signaling pathway and rational application of related inhibitors, more optimized treatment strategies for breast cancer patients are expected.

关 键 词：乳腺肿瘤 磷脂酰肌醇3-激酶抑制剂 蛋白激酶B 抑制剂 激素受体 

分 类 号：R737.9[医药卫生—肿瘤]