三阴性乳腺癌:常规和先进治疗策略的综述。
Triple-Negative Breast Cancer: A Review of Conventional and Advanced Therapeutic Strategies.
机构信息
Department of Nanoscience and Nanotechnology, CINVESTAV, Zacatenco, Avenida Instituto Politécnico Nacional 2508, Mexico City 07360, Mexico.
Centro de Investigación y Desarrollo Tecnológico en Electroquímica (CIDETEQ), Parque Tecnológico Querétaro s/n, Sanfandila. Pedro Escobedo, Querétaro 76703, Mexico.
出版信息
Int J Environ Res Public Health. 2020 Mar 20;17(6):2078. doi: 10.3390/ijerph17062078.
Triple-negative breast cancer (TNBC) cells are deficient in estrogen, progesterone and ERBB2 receptor expression, presenting a particularly challenging therapeutic target due to their highly invasive nature and relatively low response to therapeutics. There is an absence of specific treatment strategies for this tumor subgroup, and hence TNBC is managed with conventional therapeutics, often leading to systemic relapse. In terms of histology and transcription profile these cancers have similarities to BRCA-1-linked breast cancers, and it is hypothesized that BRCA1 pathway is non-functional in this type of breast cancer. In this review article, we discuss the different receptors expressed by TNBC as well as the diversity of different signaling pathways targeted by TNBC therapeutics, for example, Notch, Hedgehog, Wnt/b-Catenin as well as TGF-beta signaling pathways. Additionally, many epidermal growth factor receptor (EGFR), poly (ADP-ribose) polymerase (PARP) and mammalian target of rapamycin (mTOR) inhibitors effectively inhibit the TNBCs, but they face challenges of either resistance to drugs or relapse. The resistance of TNBC to conventional therapeutic agents has helped in the advancement of advanced TNBC therapeutic approaches including hyperthermia, photodynamic therapy, as well as nanomedicine-based targeted therapeutics of drugs, miRNA, siRNA, and aptamers, which will also be discussed. Artificial intelligence is another tool that is presented to enhance the diagnosis of TNBC.
三阴性乳腺癌(TNBC)细胞缺乏雌激素、孕激素和 ERBB2 受体表达,由于其高度侵袭性和对治疗的相对低反应性,成为一个特别具有挑战性的治疗靶点。由于缺乏针对该肿瘤亚组的特定治疗策略,因此 TNBC 采用常规疗法治疗,这往往会导致全身性复发。从组织学和转录谱来看,这些癌症与 BRCA-1 相关的乳腺癌具有相似性,并且据推测,BRCA1 通路在这种类型的乳腺癌中不起作用。在这篇综述文章中,我们讨论了 TNBC 表达的不同受体以及 TNBC 治疗药物靶向的不同信号通路的多样性,例如 Notch、Hedgehog、Wnt/b-Catenin 以及 TGF-β信号通路。此外,许多表皮生长因子受体(EGFR)、多聚(ADP-核糖)聚合酶(PARP)和哺乳动物雷帕霉素靶蛋白(mTOR)抑制剂有效地抑制了 TNBC,但它们面临着药物耐药或复发的挑战。TNBC 对常规治疗药物的耐药性有助于推进先进的 TNBC 治疗方法的发展,包括热疗、光动力疗法以及基于纳米医学的药物、miRNA、siRNA 和适体的靶向治疗,这也将在本文中进行讨论。人工智能是另一种被提出用于增强 TNBC 诊断的工具。