Xu Lili, Xu Pengtao, Wang Jingsong, Ji Hui, Zhang Lin, Tang Zhihua
Department of Pharmacy, Shaoxing People's Hospital, Shaoxing, Zhejiang, 312000, China.
Department of Pharmacy, Guangyuan Central Hospital, Guangyuan, Sichuan, 628000, China.
Eur J Pharmacol. 2025 Feb 5;988:177202. doi: 10.1016/j.ejphar.2024.177202. Epub 2024 Dec 14.
Triple-negative breast cancer (TNBC), defined by the lack of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2) expression, is acknowledged as the most aggressive form of breast cancer (BC), comprising 15%-20% of all primary cases. Despite the prevalence of TNBC, effective and well-tolerated targeted therapies remain limited, with chemotherapy continuing to be the mainstay of treatment. However, the horizon is brightened by recent advancements in immunotherapy and antibody-drug conjugates (ADCs), which have garnered the U.S. Food and Drug Administration (FDA) approval for various stages of TNBC. Poly (ADP-ribose) polymerase inhibitors (PARPi), particularly for TNBC with BRCA mutations, present a promising avenue, albeit with the challenge of resistance that must be addressed. The success of phosphoinositide-3 kinase (PI3K) pathway inhibitors in hormone receptor (HR)-positive BC suggests potential applicability in TNBC, spurring optimism within the research community. This review endeavors to offer a comprehensive synthesis of both established and cutting-edge targeted therapies for TNBC. We delve into the specifics of PARPi, androgen receptor (AR) inhibitors, Cancer stem cells (CSCs), PI3K/Protein Kinase B (AKT)/mammalian target of rapamycin (mTOR), the transforming growth factor-beta (TGF-β), Ntoch, Wnt/β-catenin, hedgehog (Hh) pathway inhibitors, Epigenetic target-mediated drug delivery, ADCs, immune checkpoint inhibitors (ICIs)and novel immunotherapeutic solutions, contextualizing TNBC within current treatment paradigms. By elucidating the mechanisms of these drugs and their prospective clinical applications, we aim to shed light on the challenges and underscore the beacon of hope that translational research and innovative therapies represent for the oncology field.
三阴性乳腺癌(TNBC)是指缺乏雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子2(HER2)表达的乳腺癌,被认为是最具侵袭性的乳腺癌形式,占所有原发性病例的15%-20%。尽管TNBC很常见,但有效且耐受性良好的靶向治疗仍然有限,化疗仍是主要的治疗手段。然而,免疫疗法和抗体药物偶联物(ADC)的最新进展为前景带来了曙光,这些疗法已获得美国食品药品监督管理局(FDA)对TNBC各个阶段的批准。聚(ADP-核糖)聚合酶抑制剂(PARPi),特别是对于具有BRCA突变的TNBC,是一条有前景的途径,尽管必须应对耐药性挑战。磷酸肌醇-3激酶(PI3K)通路抑制剂在激素受体(HR)阳性乳腺癌中的成功表明其在TNBC中可能具有适用性,这在研究界引发了乐观情绪。本综述旨在全面综合TNBC已有的和前沿的靶向治疗方法。我们深入探讨PARPi、雄激素受体(AR)抑制剂、癌症干细胞(CSC)、PI3K/蛋白激酶B(AKT)/雷帕霉素哺乳动物靶点(mTOR)、转化生长因子-β(TGF-β)、Notch、Wnt/β-连环蛋白、刺猬(Hh)通路抑制剂、表观遗传靶点介导的药物递送、ADC、免疫检查点抑制剂(ICI)和新型免疫治疗方案,将TNBC置于当前治疗模式中进行背景分析。通过阐明这些药物的作用机制及其潜在的临床应用,我们旨在揭示挑战,并强调转化研究和创新疗法为肿瘤学领域带来的希望之光。
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