NYU Langone Health, Perlmutter Cancer Center, New York, NY, USA.
NYU Langone Health, Perlmutter Cancer Center, New York, NY, USA.
Cancer Treat Rev. 2019 Sep;79:101888. doi: 10.1016/j.ctrv.2019.08.004. Epub 2019 Aug 13.
Metaplastic breast carcinomas (MPBC) are rare, aggressive and relatively chemorefractory tumors with a high unmet need. While most are "triple negative" and lack expression of estrogen, progesterone and HER2 receptors, MPBC are associated with worse outcomes compared to conventional triple negative invasive tumors. MPBCs are genetically heterogeneous and harbor somatic mutations, most frequently in TP53, PIK3CA and PTEN, with emerging studies suggesting a role for novel targeted therapies. These tumors have also been associated with overexpression of PD-L1 and tumor-infiltrating lymphocytes suggesting an endogenous immune response and therefore a rationale for treatment with immunotherapies. Here, we focus on therapeutic options for this difficult to treat breast cancer subtype and encourage physicians to consider targeted therapies/immunotherapies as part of ongoing clinical trials.
化生性乳腺癌（MPBC）是一种罕见的侵袭性和相对化疗耐药的肿瘤，具有高度未满足的需求。虽然大多数为“三阴性”，缺乏雌激素、孕激素和 HER2 受体的表达，但与传统的三阴性浸润性肿瘤相比，MPBC 的预后更差。MPBC 具有遗传异质性，存在体细胞突变，最常见于 TP53、PIK3CA 和 PTEN，新兴研究表明新型靶向治疗具有作用。这些肿瘤还与 PD-L1 和肿瘤浸润淋巴细胞的过表达相关，提示存在内源性免疫反应，因此有理由使用免疫疗法进行治疗。在这里，我们专注于这种治疗难度大的乳腺癌亚型的治疗选择，并鼓励医生考虑靶向治疗/免疫疗法作为正在进行的临床试验的一部分。
