激素受体/人表皮生长因子受体2阳性乳腺癌治疗研究进展

Research Progress in the Treatment of Hormone Receptor/Human Epidermal Growth Factor Receptor 2-positive Breast Cancer

乳腺癌是我国女性最常见的恶性肿瘤,根据雌激素受体(ER)和孕激素受体(PR)的表达以及人表皮生长因子受体2(HER2)基因的扩增状态,乳腺癌被分为多个分子亚型。不同的亚型预后也不同,其中HER2阳性(+)乳腺癌与HER2阴性(-)乳腺癌相比,更具侵袭性,且预后更差。激素受体(HR)+/HER2+乳腺癌由于在HR与HER2信号通路之间存在交互转导通路,以致内分泌治疗及抗HER2治疗相互影响、制约。如何合理而有效地治疗HR+/HER2+乳腺癌成为乳腺癌治疗的难点之一。本文简述了HR+/HER2+乳腺癌的治疗现状以及在抗HER2治疗、内分泌治疗、免疫治疗、磷脂酰肌醇3-激酶(PI3K)/雷帕霉素靶蛋白(mTOR)通路抑制剂等方面的探索之路。

Breast Cancer is the most common cancer among women in China.According to the expression of estrogen receptor(ER)and progesterone receptor(PR)and the status of human epidermal growth factor receptor 2(HER2)gene amplification,breast cancer has been classified into various molecular subtypes.And the prognosis of different subtypes is also different.HER2 positive breast cancer behaves more aggressively and has a worse prognosis than HER2 negative breast cancer.Moreover,there are interactive crosstalks between HR and HER2 signaling pathways so that endocrine therapy and anti-HER2 therapy could influence and restrict each other.Nowadays,how to treat HR+/HER2+breast cancer reasonably and effectively has been one of the difficulties in the treatment of breast cancer.In this article,the treatment situation of HR+/HER2+breast cancer and the exploration of anti-HER2 therapy,endocrine therapy,immunotherapy,PI3K/mTOR pathway inhibitors,and other aspects associated with HR+/HER2+breast cancer have been briefly described.