Klocker Eva Valentina, Suppan Christoph
Department of Oncology, Medical University of Graz, Graz, Austria.
Breast Care (Basel). 2020 Dec;15(6):586-593. doi: 10.1159/000512283. Epub 2020 Oct 28.
Breast cancer is a heterogeneous disease with well-known characteristics such as hormone receptor (HR) status and human epidermal growth factor (Her)2 status. Although Her2 represents an established treatment target, the development of resistance mechanisms during treatment, cardiotoxicity, and a worse response to standard therapies lead to worse outcomes.
Therefore, we investigated various biomarkers in breast cancer such as Her2 mutations, Her2 heterogeneity, HR, PIK3CA, PTEN, programmed death receptor ligand 1 (PD-L1), tumor-infiltrating lymphocytes (TIL), micro RNA (miRNA), and BRCA mutations with regard to their clinical impact in Her2-positive disease. HR status and Her2 status, such as the presence of PIK3CA mutations, already play a role in treatment decision-making processes, whereas other biomarkers like PD-L1 status or TIL represent promising future markers. The influence of BRCA mutations in Her2-positive disease, Her2 mutations, and the impact of miRNA is vague to date. Antibody-drug conjugates (ADC) such as T-DM have been established as important treatment strategies, especially in Her2-positive disease.
However, up-to-date biomarkers appropriate for clinical practice are missing. Further studies are needed.
乳腺癌是一种异质性疾病，具有激素受体（HR）状态和人表皮生长因子（Her）2状态等众所周知的特征。尽管Her2是一个既定的治疗靶点，但治疗期间耐药机制的出现、心脏毒性以及对标准疗法的较差反应导致预后更差。
因此，我们研究了乳腺癌中的各种生物标志物，如Her2突变、Her2异质性、HR、PIK3CA、PTEN、程序性死亡受体配体1（PD-L1）、肿瘤浸润淋巴细胞（TIL）、微小RNA（miRNA）和BRCA突变，以了解它们在Her2阳性疾病中的临床影响。HR状态和Her2状态，如PIK3CA突变的存在，已经在治疗决策过程中发挥作用，而其他生物标志物如PD-L1状态或TIL则代表着有前景的未来标志物。迄今为止，BRCA突变在Her2阳性疾病中的影响、Her2突变以及miRNA的影响尚不清楚。抗体药物偶联物（ADC）如T-DM已被确立为重要的治疗策略，尤其是在Her2阳性疾病中。
然而，目前缺乏适用于临床实践的生物标志物。需要进一步研究。
