Department of Medicine (DAME), University of Udine, 33100 Udine, Italy.
Clinical Medicine and Surgery Department, University of Naples Federico II, 80131 Naples, Italy.
Cancer Treat Rev. 2018 Jul;68:102-110. doi: 10.1016/j.ctrv.2018.06.005. Epub 2018 Jun 11.
Triple negative breast cancer (TNBC) represents the 15-20% of all breast cancers (BC) and is characterized by a very aggressive behavior. Recent data suggest that TNBC is not a single disease, but it is rather an umbrella for different ontology-profiles such as basal like 1 and 2, mesenchymal, and the luminal androgen receptor (LAR). The LAR subtype is characterized by the expression of the Androgen Receptor (AR) and its downstream effects. Notwithstanding the role of the AR in several signaling pathways, its impact on a biological and clinical standpoint is still controversial. The LAR subtype has been associated with better prognosis, less chemotherapy responsiveness and lower pathologic complete response after neoadjuvant treatment. Clinical evidence suggests a role for anti-androgen therapies such as bicalutamide, enzalutamide and abiraterone, offering an interesting chemo-free alternative for chemo-unresponsive patients, and therefore potentially shifting current treatment strategies.
三阴性乳腺癌(TNBC)占所有乳腺癌(BC)的 15-20%,其特征为侵袭性很强。最近的数据表明,TNBC 不是一种单一的疾病,而是不同表型谱的统称,如基底样 1 和 2、间质型和腔面雄激素受体(LAR)型。LAR 亚型的特征是雄激素受体(AR)的表达及其下游效应。尽管 AR 在几个信号通路中起作用,但它对生物学和临床的影响仍存在争议。LAR 亚型与更好的预后相关,对化疗的反应性较低,新辅助治疗后病理完全缓解率较低。临床证据表明抗雄激素治疗(如比卡鲁胺、恩扎鲁胺和阿比特龙)具有作用,为化疗无应答患者提供了一种有趣的无化疗选择,从而可能改变当前的治疗策略。