Vidula Neelima, Rugo Hope S
a Division of Hematology and Oncology , Massachusetts General Hospital , Boston , MA , USA.
b Division of Hematology and Oncology , University of California San Francisco, Helen Diller Family Comprehensive Cancer Center , San Francisco , CA , USA.
Expert Rev Anticancer Ther. 2018 Jan;18(1):3-18. doi: 10.1080/14737140.2018.1412259. Epub 2017 Dec 8.
Hormone receptor positive (HR+) breast cancer represents the most common subtype of breast cancer. Metastatic HR+ breast cancer may develop resistance to standard hormone therapies, arising from genomic alterations in the estrogen receptor and/or upregulation of other signal transduction pathways. Areas covered: In this review, we discuss hormone resistance and strategies to overcome it, from the pre-clinical and clinical perspectives. This review includes a discussion of inhibition of the PI3K/AKT/mTOR, CDK 4/6, histone deacetylation, fibroblast growth factor receptor, and immune pathways, based on review of relevant literature. Expert commentary: Several emerging novel therapies to improve the response to hormone therapy are approved or are in development. The most promising agents at present are inhibitors of CDK 4/6 and mTOR, which have already been incorporated into treatment in the advanced stage setting and are under study for early stage disease.
激素受体阳性（HR+）乳腺癌是最常见的乳腺癌亚型。转移性HR+乳腺癌可能会对标准激素疗法产生耐药性，这是由雌激素受体的基因组改变和/或其他信号转导通路的上调引起的。涵盖领域：在本综述中，我们从临床前和临床角度讨论激素耐药性及其克服策略。基于相关文献综述，本综述包括对PI3K/AKT/mTOR、CDK 4/6、组蛋白去乙酰化、成纤维细胞生长因子受体和免疫通路抑制的讨论。专家评论：几种新兴的改善激素治疗反应的新型疗法已获批准或正在研发中。目前最有前景的药物是CDK 4/6和mTOR抑制剂，它们已被纳入晚期治疗，并且正在进行早期疾病的研究。
