HER2低表达乳腺癌治疗新进展

New Advances in Treatment of HER2-Low Breast Cancer

乳腺癌是目前女性较常见的恶性肿瘤,先前的指南建议将乳腺癌关键生物标志物之一-人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)二分类,即分为阳性或阴性,以指导临床医生的治疗决策。而近半数乳腺癌患者HER2免疫组织化学(immunohistochemistry,IHC)为低表达(1+或2+)及原位杂交(in situ hybridization,ISH)检测阴性,这类患者对传统抗HER2靶向治疗并不敏感。然而新型抗HER2靶向抗体-药物偶联物(antibody-drug conjugates,ADC)为乳腺癌HER2低表达患者提供了新的靶向治疗选择,挑战了传统的二分类概念,引起了研究热潮。最新的ASCO/CAP乳腺癌HER2检测指南中已将HER2低表达乳腺癌作为临床治疗亚组。本文将从HER2低表达乳腺癌定义、ADC等药物治疗进展及该亚组目前所面临的挑战进行综述。

Currently,breast cancer is a common malignancy in female,and previous guidelines recommended that one of the key biomarkers for breast cancer,human epidermal growth factor receptor 2(HER2),is classified as either positive or negative to guide clinicians’treatment decisions.While nearly half of breast cancer patients have low HER2 expression(IHC expression is 1+or 2+and ISH detection is negative),such patients are insensitive to traditional anti-HER2 targeted therapy.However,novel antibody-drug conjugates(ADCs)provide new targeted therapy options for breast cancer patients with low HER2 expression,challenging the traditional binary concept and arousing research enthusiasm.In the latest ASCO/CAP guidelines for HER2 detection in breast cancer,HER2-low breast cancer has been included as a clinical treatment subgroup.This article will review the definition of HER2-low breast cancer,the progress of drug therapy such as ADC,and the current challenges faced by this subgroup.