【摘要】 目的三阴性乳腺癌(triple negative breast cancer,TNBC)是最具侵袭性的乳腺癌亚型,在乳腺癌中占15%~20%。目前尚无批准的靶向治疗可用于TNBC。与其他乳腺癌亚型相比,TNBC表皮生长因子受体(epidermal growth factor receptor,EGFR)通常过表达,这对该疾病来说是一个潜在治疗靶点。本研究总结TNBC治疗现状、研究方向及进展,靶向治疗在TNBC中应用的可能性,探讨其产生及获得耐药性的潜在因素。方法应用PubMed数据库检索系统,以"TNBC、靶向治疗、EGFR抑制剂和耐药性"等为关键词,检索2005-01-2017-03的相关文献。纳入标准:(1)TNBC治疗现状;(2)TNBC的靶向治疗;(3)靶向治疗耐药的机制。排除标准:(1)非TNBC的治疗现状;(2)非TNBC的治疗策略;(3)非TNBC治疗的耐药机制。根据纳入和排除标准,选择符合分析的文献34篇。结果目前TNBC靶向治疗缺乏响应,有必要对TNBC病患进行分层,开发有效的联合疗法来提高靶向治疗效用。蛋白质精氨酸甲基转移酶1(recombinant human protein arginine methyltransferase 1,PRMT1)抑制剂与EGFR单抗(monoclonal antibody,mAb),及小分子酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)与抗多聚(ADP-核糖)聚合酶(poly ADP-ribose polymerase,PARP)抑制剂的联合用药或许会成为TNBC的有效治疗策略。EGFR单抗和免疫检查点抑制剂的联合用药或许会成为一种有前景的治疗方法。结论 TNBC的抗EGFR靶向治疗或许是一种可行的治疗方式,尽管目前没有专门批准用于TNBC治疗的药物,但相关临床试验正在进行中,将为以后的治疗带来启示。更多还原

【Abstract】 OBJECTIVE Triple-negative breast cancer(TNBC)is the most aggressive breast cancer subtype and accounts for about 15%-20% of breast cancers.Currently,there is no approved targeted therapy available for TNBCs.Compared with other breast cancer subtypes,EGFR is frequently overexpressed in TNBC which could be a potential therapeutic target for this disease.In this review,we summarized the current situation,research direction and progression of TNBC,discuss the possibility of target therapy in TNBC and explore the potential molecular mechanism of drug resistance.METHODS We retrieved the articles from January 2005 to March 2017 by PubMed database retrieval system with"TNBC,target therapy,EGFR inhibitors and drug resistance"as key words,and selected data according to the inclusion criteria as follows:(1)Current treatment status for TNBC;(2)Target therapy for TNBC;(3)the drug resistance mechanism of target therapy in TNBC.The exclusion criteria:(1)Current treatment status for non-TNBC;(2)treatment strategies for non-TNBC;(3)the drug resistance mechanism of treatment in non-TNBC.According to the inclusion criteria,34 articles meet the requirements.RESULTS Currently,the target therapy in TNBCs is lack of response,and it is necessary to stratify patients to enhance the efficacy of target therapy in TNBC and to develop the effective combination therapy for this patient population.The combination of EGFR mAbs and PRMT1 inhibitors,or TKIs and PARP inhibitors may be effective therapeutic strategies against TNBC.In addition,the combination of EGFR mAb and immune checkpoint inhibitors may be promising therapeutic approaches for TNBC.CONCLUSIONS The anti-EGFR therapies targeting TNBC may be promising therapeutic approaches,through there is no effective target therapy for the treatment of TNBC.However,a variety of experiments are underway to bring us enlightenment.更多还原