Pizzuti Laura, Krasniqi Eriseld, Barchiesi Giacomo, Mazzotta Marco, Barba Maddalena, Amodio Antonella, Massimiani Gioia, Pelle Fabio, Kayal Ramy, Vizza Enrico, Grassadonia Antonino, Tomao Silverio, Venuti Aldo, Gamucci Teresa, Marchetti Paolo, Natoli Clara, Sanguineti Giuseppe, Ciliberto Gennaro, Vici Patrizia
Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00144 Rome, Italy.
Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Azienda Ospedaliera Sant'Andrea, 00189 Rome, Italy.
J Cancer. 2019 Oct 12;10(24):5903-5914. doi: 10.7150/jca.35109. eCollection 2019.
Triple negative breast cancer (TNBC) is characterized by distinctive biological features that confer an aggressive clinical behavior. In TNBC patients, the absence of well-defined driver pathways such as hormonal receptor expression or hyperactivation of the human epidermal growth factor receptor 2 (HER2) significantly reduce the spectrum of therapeutic options, which are currently mainly confined to chemotherapy. Thus far, median overall survival for patients with metastatic TNBC is about 9-12 months with conventional cytotoxic agents. However, the heterogeneity recently revealed at a gene expression level inside the TNBC family may help inform therapeutic decisions concerning the use of chemotherapy and hopefully lead the way to novel targeted options that include immunotherapy. Eribulin, a halichondrin class antineoplastic drug, is currently recommended for treatment of HER2 negative metastatic or recurrent breast cancer (BC) previously exposed to anthracyclines and taxanes, also for patients with a TNBC. It is currently indicated from the second line of treatment. In this review, we aim to analyze a wide range of cumulated evidence on eribulin use in TNBC including preclinical studies, intervention and observational clinical trials. Data from the real-world setting and the emerging evidence increasingly substantiating the rationale for combinations with new generation treatment strategies, e.g., PARP-inhibitors, immune checkpoint inhibitors, will be also discussed.
三阴性乳腺癌（TNBC）具有独特的生物学特征，这些特征导致其临床行为具有侵袭性。在TNBC患者中，由于缺乏明确的驱动途径，如激素受体表达或人表皮生长因子受体2（HER2）的过度激活，使得治疗选择范围显著缩小，目前主要局限于化疗。迄今为止，使用传统细胞毒性药物治疗转移性TNBC患者的中位总生存期约为9至12个月。然而，最近在TNBC家族内部基因表达水平上揭示的异质性可能有助于指导关于化疗使用的治疗决策，并有望引领包括免疫疗法在内的新型靶向治疗方案的发展。艾日布林是一种软海绵素类抗肿瘤药物，目前被推荐用于治疗先前接受过蒽环类药物和紫杉烷类药物治疗的HER2阴性转移性或复发性乳腺癌（BC）患者，也适用于TNBC患者。目前它被用于二线治疗。在本综述中，我们旨在分析关于艾日布林在TNBC中应用的广泛累积证据，包括临床前研究、干预性和观察性临床试验。来自真实世界的数据以及越来越多的新证据也将被讨论，这些证据越来越多地证实了与新一代治疗策略（如PARP抑制剂、免疫检查点抑制剂）联合使用的合理性。
