靶向HER2胞外结构域Ⅳ的单克隆抗体在乳腺癌中的应用进展

Clinical application and progression of monoclonal antibodies targeting HER2 extracellular domainⅣin breast cancer

人表皮生长因子受体2(HER2)阳性乳腺癌侵袭性强且易转移,抗HER2靶向药物的应用能显著改善HER2阳性乳腺癌患者的预后。在已上市的HER2靶向药物中,靶向HER2胞外结构域Ⅳ的大分子单克隆抗体是治疗HER2阳性乳腺癌的基础靶向药物,主要包括曲妥珠单抗、伊尼妥单抗和马吉妥昔单抗。曲妥珠单抗用于乳腺癌全线治疗,循证医学证据充分,实践经验充足且安全性可控;伊尼妥单抗与曲妥珠单抗在HER2阳性转移性乳腺癌和新辅助/辅助治疗中疗效相似,且安全性可控;马吉妥昔单抗聚焦于携带CD16A-158F等位基因的患者,是晚期乳腺癌后线治疗的选择。临床上需根据患者具体病情选择最适合的药物。

Human epidermal growth factor receptor 2(HER2)-positive breast cancer is aggressive and prone to metastasis,and the applications of HER2 agents have improved the prognosis of patients with HER2-positive breast cancer.Among the marketed HER2 agents,macromolecular monoclonal antibodies that target the extracellular domainⅣof HER2 were the cornerstone drugs of HER2-positive breast cancer,including trastuzumab,inetetamab,and margetuximab.Trastuzumab is available for the full-line treatment of breast cancer with sufficient proof of evidence-based medicine,sufficient practical experience and controllable safety.Inetetamab and trastuzumab have similar efficacy and controllable safety in HER2-positive metastatic breast cancer and neoadjuvant/adjuvant therapy.Margetuximab focuses on patients carrying the CD16A-158F allele,and is an option of posterior line treatment for advanced breast cancer.It is necessary to select the most suitable drugs clinically according to the specific condition of the patient.