Fan Pinchao, Xu Kun
The First Clinical Medical College of Nanjing Medical University, Nanjing 211166, China.
Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, 42 Baiziting, Nanjing 210009, China.
Biochim Biophys Acta Rev Cancer. 2023 Jan;1878(1):188849. doi: 10.1016/j.bbcan.2022.188849. Epub 2022 Dec 9.
The recent decade has witnessed a vigorous prosper of antibody-drug conjugates (ADCs) in solid tumors including breast cancer. Integrating the specificity of monoclonal antibodies and potency of cytotoxic drugs, ADCs are capable of delivering cytotoxic agents directly to tumor cells and surrounding accomplices with heterogeneous antigen expression by exerting the distinctive bystander effect. Up till now, three ADCs (T-DM1, T-DXd and SG) have attained the official approval and stepped into clinical practices in breast cancer, with numerous promising products in the pipeline. As an unprecedented breast cancer subgroup identified following solidified drug benefit, the cognitive and therapeutic paradigm of HER2-low population which was previously thought lacking definite targets and efficacious regimens has been thoroughly rewritten by ADCs, and several encouraging achievements are expected in ongoing trials. Herein, we discuss the contrived knowledge, latest advancements and future perspectives of ADCs in HER2-overexpressing and HER2-low breast cancer.
近十年来，抗体药物偶联物（ADC）在包括乳腺癌在内的实体瘤中蓬勃发展。ADC整合了单克隆抗体的特异性和细胞毒性药物的效力，能够通过发挥独特的旁观者效应，将细胞毒性药物直接递送至肿瘤细胞以及周围具有异质性抗原表达的协同细胞。截至目前，三种ADC（曲妥珠单抗-美坦新偶联物、德曲妥珠单抗和戈沙妥珠单抗）已获得正式批准并应用于乳腺癌临床实践，还有众多前景看好的产品正在研发中。作为在明确药物获益后确定的一个前所未有的乳腺癌亚组，之前被认为缺乏明确靶点和有效治疗方案的HER2低表达人群的认知和治疗模式已被ADC彻底改写，在正在进行的试验中有望取得几项令人鼓舞的成果。在此，我们讨论ADC在HER2过表达和HER2低表达乳腺癌中的既定知识、最新进展和未来前景。
