Stella Stefania, Martorana Federica, Massimino Michele, Vitale Silvia Rita, Manzella Livia, Vigneri Paolo
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Center of Experimental Oncology and Hematology, A.O.U. Policlinico "G. Rodolico - San Marco", Catania, Italy.
Onco Targets Ther. 2023 Apr 7;16:235-247. doi: 10.2147/OTT.S379867. eCollection 2023.
Luminal Androgen Receptor Breast Cancers (LAR BCs) are characterized by a triple negative phenotype and by the expression of Androgen Receptor (AR), coupled with luminal-like genomic features. This unique BC subtype, accounting for about 10% of all triple negative BC, has raised considerable interest given its ill-defined clinical behavior and the chance to exploit AR as a therapeutic target. The complexity of AR activity in BC cells, as revealed by decades of mechanistic studies, holds promise to offer additional therapeutic options beyond mere AR inhibition. Indeed, preclinical and translational evidence showed that several pathways and mediators, including PI3K/mToR, HER2, BRCA1, cell cycle and immune modulation, can be tackled in LAR BCs. Moving from bench to bedside, several clinical trials tested anti-androgen therapies in LAR BCs, but their results are inconsistent and often disappointing. More recently, studies exploring combinations of anti-androgen agents with other targeted therapies have been designed and are currently ongoing. While the results from these trials are awaited, a concerted effort will be needed to find the biological vulnerabilities of LAR BCs which may disclose new and effective therapeutic targets, eventually improving patients' outcomes.
管腔雄激素受体乳腺癌(LAR BC)的特征是三阴性表型以及雄激素受体(AR)的表达,并伴有管腔样基因组特征。这种独特的乳腺癌亚型约占所有三阴性乳腺癌的10%,鉴于其不明确的临床行为以及将AR作为治疗靶点的可能性,引起了人们的极大兴趣。数十年的机制研究揭示了BC细胞中AR活性的复杂性,有望提供除单纯AR抑制之外的其他治疗选择。事实上,临床前和转化研究证据表明,包括PI3K/mToR、HER2、BRCA1、细胞周期和免疫调节在内的多种途径和介质都可以在LAR BC中得到解决。从实验室走向临床,多项临床试验在LAR BC中测试了抗雄激素疗法,但其结果并不一致,且往往令人失望。最近,探索抗雄激素药物与其他靶向疗法联合使用的研究已经设计出来,目前正在进行中。在等待这些试验结果的同时,需要共同努力找到LAR BC的生物学脆弱性,这可能会揭示新的有效治疗靶点,最终改善患者的预后。