晚期胆道癌抗HER-2治疗临床研究进展

Clinical research progress of anti⁃HER⁃2 therapy for advanced biliary tract cancer

胆道癌(BTC)是起源于胆管上皮的一组恶性肿瘤,异质性高,治疗棘手,预后差,生存期短。晚期BTC的治疗既往主要依赖于化疗,新近免疫联合化疗一线治疗已获得成功;同时,随着对胆道肿瘤的基因组和蛋白组特征认识的不断加深,业已明确其分子分型,且发现了若干分子生物标志物,因此靶向药物在二线治疗BTC的研究如火如荼,正在改变BTC的治疗格局和结局。抗人表皮生长因子受体-2(HER-2)治疗,已在乳腺癌和胃癌等多种肿瘤的治疗中显著改善患者预后,现正在积极探索用于治疗BTC,初步显示了可期的美好前景。本文简要综述了抗HER-2治疗BTC的临床研究进展,提出需要进一步开展基于分子生物标志物HER-2驱动的随机对照、大规模的多中心Ⅲ期研究。

Biliary tract carcinomas(BTCs)are a group of malignant tumors originating from the bile duct epithelium cell with high heterogeneity,difficult treatment,but have a poor prognosis and short survival.In the past,the treatment of advanced BTC mainly relied on chemotherapy.Recently,immunotherapy combined with chemotherapy as first-line treatment has been successful.At the same time,with the deepening understanding of the genomic and proteomic characteristics of biliary tract tumors,its molecular classification has been clarified,and several molecular biomarkers have been discovered.Therefore,the researches of some molecular targeted drugs for the second-line treatment of BTC are in full progress,which are changing the treatment pattern and outcome of BTC.Anti-human epidermal growth factor receptor 2(HER-2)therapy,which has significantly improved the prognosis of patients with a variety of tumors such as breast cancer and gastric cancer,is being actively explored for the treatment of BTC,and has initially shown promising prospects.This article briefly reviews the clinical research progress of anti-HER-2 therapy for BTC,and puts forward the need for further randomized controlled,large-scale,multi-center phaseⅢstudies based on molecular biomarkers HER-2-driven.