HR+/HER2+晚期乳腺癌药物治疗方案选择的研究进展

Progress of hormone receptor positive and human epidermal growth factor receptor 2 positive advanced breast cancer

激素受体阳性/人表皮生长因子受体2阳性乳腺癌是一种具有独特特征的乳腺癌亚型。国内外指南建议,无论HR状态如何,含抗HER2治疗的联合方案(如曲妥珠单抗和帕妥珠单抗)应作为HER2+晚期乳腺癌的一线治疗。内分泌治疗可作为不能耐受化疗或化疗后患者的维持治疗。既往研究表明,HR通路与HER2通路相互作用,内分泌联合靶向治疗可有效避免肿瘤耐药。因此,内分泌联合靶向治疗是HR+/HER2+患者替代化疗的首选治疗方案。文章对HR+/HER2+乳腺癌的生物学特征、诊疗现状及未来研究方向进行综述。

Hormone receptor(HR)positive/human epidermal growth factor receptor 2(HER2)positive(HR+/HER2+)advanced breast cancer(ABC)is a subtype of breast cancer with unique characteristics.Domestic and international guidelines suggest that combination therapy with anti-HER2 therapy(trastuzumab and pertuzumab)should be the first-line treatment for advanced HER2+breast cancer,regardless of HR status.Endocrine therapy can be used as maintenance therapy for patients who are intolerant to chemotherapy or after chemotherapy.Previous studies have shown that the HR pathway interacts with the HER2 pathway.And combined endocrine targeted therapy can effectively avoid anti-tumor drug resistance.Therefore,combined endocrine targeted therapy is the preferred alternative to chemotherapy for HR+/HER2+patients.The biological characteristics,diagnosis and treatment status and future research directions of HR+/HER2+breast cancer will be reviewed in this article.