Arslan Cagatay, Dizdar Omer, Altundag Kadri
Hacettepe University Institute of Oncology, Department of Medical Oncology, 06100 Sihhiye, Ankara, Turkey.
Expert Opin Pharmacother. 2009 Sep;10(13):2081-93. doi: 10.1517/14656560903117309.
The term 'triple-negative breast cancer' defines tumors that do not express estrogen receptors, progesterone receptors or Her2 on immunohistochemical analysis. This subgroup accounts for 15% of all types of breast cancer. Histologically, triple-negative breast cancers are poorly differentiated and are characterized by an aggressive clinical history. A significant overlap exists in biological and clinical characteristics of basal-like breast cancer and triple-negative breast cancer. Treatment options are limited, as these tumors lack a therapeutic target and are naturally resistant to existing targeted therapies, i.e., endocrine treatment and trastuzumab. As there are no specific treatment guidelines for this subgroup, triple-negative breast cancers are managed with standard treatment; however, local and systemic relapse rates are high due to the adverse biology of the disease. Triple-negative breast cancer has many histological and genetic similarities with BRCA-1-associated breast cancer, suggesting a common pathogenesis and the potential use of common chemotherapeutics in both cancers. This review discusses current and future treatment options in the light of the new insights in major proliferative pathways active in the pathogenesis of triple-negative breast cancer.
术语“三阴性乳腺癌”指的是在免疫组织化学分析中不表达雌激素受体、孕激素受体或Her2的肿瘤。这一亚组占所有类型乳腺癌的15%。从组织学上看，三阴性乳腺癌分化较差，临床病程具有侵袭性。基底样乳腺癌和三阴性乳腺癌在生物学和临床特征上存在显著重叠。由于这些肿瘤缺乏治疗靶点且对现有的靶向治疗（即内分泌治疗和曲妥珠单抗）天然耐药，治疗选择有限。由于该亚组没有特定的治疗指南，三阴性乳腺癌采用标准治疗；然而，由于疾病的不良生物学特性，局部和全身复发率很高。三阴性乳腺癌与BRCA-1相关乳腺癌在组织学和遗传学上有许多相似之处，提示两者有共同的发病机制以及在两种癌症中使用共同化疗药物的可能性。本综述根据三阴性乳腺癌发病机制中主要增殖途径的新见解，讨论了当前和未来的治疗选择。
