乳腺癌内分泌治疗耐药及其逆转的研究进展

孙文婧; 胡曼婷; 李娜; 葛菲; 陈文林; 刘洋

doi:10.12259/j.issn.2095-610X.S20210724

乳腺癌内分泌治疗耐药及其逆转的研究进展

doi: 10.12259/j.issn.2095-610X.S20210724

孙文婧¹,
胡曼婷¹,
李娜¹,
葛菲¹,
陈文林^2, ,,
刘洋²

1.
昆明医科大学第三附属医院乳腺外一科、云南省肿瘤医院，云南昆明　650118
2.
昆明医科大学第一附属医院乳腺外科，云南昆明　650032

基金项目: 国家自然科学基金资助项目（82060538）；云南省卫生健康委员会医学学科带头人培养计划（D-2018002）

详细信息

作者简介:
孙文婧（1995～），女，江西九江人，在读硕士研究生，主要从事乳腺肿瘤基础研究工作

通讯作者:
陈文林，E-mail：chenwenlin@aliyun.com

中图分类号: R737.9
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出版历程
- 收稿日期: 2021-05-09
- 网络出版日期: 2021-07-19
- 刊出日期: 2021-07-21

Progress in Clinical Research on Drug Resistance and Reversal of Endocrine Therapy in Breast Cancer

1.
NO 1 Department of Breast Surgery，The Third Affiliated Hospital of Kunming Medical University，Yunnan Cancer Hospital，Kunming Yunnan 650118
2.
Dept. of Breast Surgery，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032，China

摘要

摘要: 激素受体阳性HR + 乳腺癌临床治疗初始阶段依靠内分泌治疗常取得较好的预后，但一旦出现复发和转移，总的预后并不理想，因此近年来内分泌治疗的疗效因耐药性的产生而受到各种限制，内分泌耐药的逆转被认为是让早期激素受体阳性乳腺癌回归慢性疾病治疗的新的方法和希望，延缓和逆转内分泌耐药的策略也逐渐受到临床和科研工作密切的关注。对延缓和逆转内分泌治疗以及应对策略的研究进展作一综述。
- 乳腺癌 /
- 内分泌治疗 /
- 耐药 /
- 逆转
Abstract: In the initial stage of clinical treatment of hormone receptor positive HR + breast cancer, good prognosis is often achieved by endocrine therapy. Once recurrence and metastasis occur, the overall prognosis is not ideal. Therefore, the efficacy of endocrine therapy is limited by the emergence of drug resistance these years. The reversal of endocrine resistance is considered to be a new method and hope for early hormone receptor positive breast cancer to return to chronic disease treatment. The strategy of delaying and reversing endocrine drug resistance has been paid close attention by clinical and scientific research work. This article will review the research progress and strategies of delaying and reversing endocrine therapy.
- Breast cancer /
- Endocrine therapy /
- Drug resistance /
- Reversal

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图 1 内分泌治疗的经典药物和联合靶向药物的相关通路和作用位点

Figure 1. Related pathways and action sites of classical drugs and combined targeted drugs in endocrine therapy

下载: 全尺寸图片幻灯片

表 1 HR+乳腺癌的内分泌联合治疗

Table 1. Endocrine combined therapy for HR + breast cancer

药物类别/靶点	药物名称	临床研究	研究设计	无进展生存时间/月
EGFR inhibitors	Gefitinib	NCT00229697^[2]	Tamoxifen + Gefitinib vs placebo	10.9 vs 8.8
EGFR inhibitors	Gefitinib	NCT00057941^[5]	Gefitinib + Anastrozole vs Gefitinib + Fulvestrant	5.3 vs 5.2
Molecular targeted agents	Trastuzumab	TAnDEM-3^[3]	Trastuzumab + Anastrozole vs anastrozole	4.8 vs 2.4 5.6 vs 3.8
Molecular targeted agents	Margetuximab	SOPHIA-3^[4]	Margetuximab + chemotherapy vs Trastuzumab+ chemotherapy	6.9 vs 5.1
CDK4/6 inhibitors	Abemaciclib	MONARCH-3^[7]	Abemaciclib/placebo+ non-steroidal drugs	28.18 vs 14.76
	palbociclib	NCT02549430^[8]	Palbociclib + ET vs palbociclib	10.8 vs 6.5
	Ribociclib	MalAlESA-2^[9]	Ribociclib + Letrozole vs ribociclib + placebo	25.3 vs 16.0
PI3K/AKT/mTOR inhibitors	buparlisib	BELLE-2^[10]	Buparlisib + Fulvestrant vs placebo	6.9 vs 5.0； 6.8 vs 4.5； 6.8 vs 4.0
	Pictilisib	NCT01437566^[11]	Pictilisib + Fulvestrant vs placebo	6.5 vs 5.1
	Alpelisib	BYL719-1b^[12]	Alpelisib + Letrozole vs placebo	-N/A
	MK-2206	NCT01344031^[14]	MK-2206 + Fulvestrant vs placebo	N/A-

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参考文献(24)

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