吡咯替尼在HER2阳性晚期乳腺癌中的研究进展

Progress of pyrotinib in HER2 positive advanced breast cancer

人表皮生长因子受体2(HER2)阳性乳腺癌恶性程度高,预后差。多种抗HER2靶向药物的问世为治疗HER2阳性乳腺癌提供了更加精准和优化的方案,从而延长了患者生存时间,改善了患者预后。酪氨酸激酶抑制剂(TKIs)是一种临床上有效的抗HER2治疗药物。吡咯替尼作为我国国产原研的新型不可逆小分子TKIs,因具备靶点多、易通过血脑屏障、可口服、毒性较小等优点在临床应用中越来越受重视。临床研究表明,吡咯替尼治疗HER2阳性晚期乳腺癌特别是伴有脑转移的患者疗效显著,延长了患者的生存时间,且其不良反应可控。虽然有关吡咯替尼的真实世界研究数据较少,但目前的数据表明,对于HER2阳性晚期乳腺癌患者,吡咯替尼展现出了潜在的治疗优势。近年来,吡咯替尼在乳腺癌诊疗指南中的地位稳步上升,极大弥补了国内抗HER2药物的不足,为HER2阳性乳腺癌患者提供了更多的治疗选择,改善了患者预后。本研究就吡咯替尼在HER2阳性晚期乳腺癌中的作用机制、临床疗效、药物不良反应以及吡咯替尼在真实世界中的研究及展望进行探讨。

Human epidermal growth factor-2(HER2) positive breast cancer has a high degree of malignancy and poor prognosis.The advent of a variety of anti-HER2 targeted drugs has provided more accurate and optimized plans for the treatment of HER2 positive breast cancer, thus significantly extending the survival of patients and improving their prognosis.Tyrosine kinase inhibitors(TKIs) is an effective therapeutic agent against HER2.Pyrotinib, as a novel irreversible small molecule TKIs developed in China, has attracted more and more attention in clinical application due to its advantages of multiple targets, easy to pass the blood-brain barrier, oral administration and low toxicity.Clinical studies have shown that Pyrotinib has significant efficacy in the treatment of HER2 positive advanced breast cancer, especially in patients with brain metastasis, which prolongs the survival of patients and has controllable adverse reactions.Although there are few real-world studies on Pyrotinib, current data suggest that Pyrotinib presents a potential therapeutic advantage for patients with HER2 positive advanced breast cancer.In recent years, the significance of Pyrotinib in the breast cancer guidelines has been steadily rising, and its advent has greatly made up for the shortage of domestic anti-HER2 drugs, providing more treatment options for patients with HER2 positive breast cancer and improving the prognosis of patients.This review will discuss the mechanism of action, clinical efficacy, adverse drug reactions of Pyrotinib in HER2 positive advanced breast cancer, as well as the research and prospects of Pyrotinib in the real world.