Lluch Ana, Eroles Pilar, Perez-Fidalgo Jose-Alejandro
Hospital Clinico Universitario, INCLIVA Biomedical Research Institute, Department of Oncology and Hematology , Valencia , Spain +0034 963987659 ;
Expert Opin Emerg Drugs. 2014 Jun;19(2):165-81. doi: 10.1517/14728214.2014.903919. Epub 2014 May 15.
The EGFR has been associated with the pathogenesis and progression of breast cancer. Treatment based on an EGFR target is emerging as a promising option, especially in combination with conventional therapies. Unfortunately, there are no validated predictor biomarkers, and combinatorial treatments are meeting new resistance.
The purpose of this review is to summarize the existing treatments and the current research based on targeting the EGFR pathway.
The existing EGFR treatments in breast cancer have shown limited benefit. The combination of the monoclonal antibody cetuximab and platinum salts achieves a 15 - 20% response rate. The effectiveness of tyrosine kinase inhibitors is not completely clear, showing modest or no benefits. Gefitinib treatment has offered some promising results in estrogen receptor + breast cancer. However, it has not been identified as a predictive factor for the appropriate selection of patients. Radioimmunotherapy with anti-EGFR radiolabeled antibodies is a promising strategy in BRCA-mutated breast cancer, but it still requires clinical confirmation. Nevertheless, the crosstalk between pathways frequently leads to treatment resistance. Current research is focused on increasing knowledge about the mechanisms of response and the discovery of predictive markers. Targeting several pathways simultaneously and a correct selection of patients seem essential.
表皮生长因子受体(EGFR)与乳腺癌的发病机制及进展相关。基于EGFR靶点的治疗正成为一种有前景的选择,尤其是与传统疗法联合使用时。不幸的是,目前尚无经过验证的预测生物标志物,且联合治疗正面临新的耐药问题。
本综述的目的是总结基于靶向EGFR通路的现有治疗方法及当前研究。
乳腺癌中现有的EGFR治疗方法显示出有限的益处。单克隆抗体西妥昔单抗与铂盐联合使用的缓解率为15% - 20%。酪氨酸激酶抑制剂的有效性尚不完全明确,显示出适度或无益处。吉非替尼治疗在雌激素受体阳性乳腺癌中取得了一些有前景的结果。然而,尚未确定其作为患者合适选择的预测因素。用抗EGFR放射性标记抗体进行放射免疫治疗在BRCA突变型乳腺癌中是一种有前景的策略,但仍需临床验证。尽管如此,通路间的相互作用常常导致治疗耐药。当前研究集中在增加对反应机制的了解以及发现预测标志物。同时靶向多个通路以及正确选择患者似乎至关重要。