Habibi Sina, Bahramian Shabbou, Zare Jalise Saeedeh, Mehri Sara, Ababzadeh Shima, Kavianpour Maria
Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Qom University of Medical Sciences, Qom, Iran.
Crit Rev Oncol Hematol. 2025 Jul;211:104715. doi: 10.1016/j.critrevonc.2025.104715. Epub 2025 Apr 3.
Breast cancer (BC) is the most common malignancy among women and a leading cause of cancer-related mortality worldwide. Although improvements in early detection and therapy have been made, metastatic breast cancer (mBC) continues to be an incurable disease. Although existing treatments can prolong survival and enhance quality of life, they do not provide a definitive cure. Targeted therapies have significantly improved outcomes, particularly for subtypes such as human epidermal growth factor receptor 2 (HER2)-positive and hormone receptor (HR)-positive (HR+) BC. Key innovations include antibodydrug conjugates (ADCs) and next-generation endocrine therapies. ADCs combine monoclonal antibodies with cytotoxic agents, allowing targeted delivery to tumor cells while minimizing systemic toxicity. Immunotherapy is emerging as a promising approach for aggressive subtypes, such as triple-negative breast cancer (TNBC). Strategies under investigation include chimeric antigen receptor T-cell (CAR-T) therapy, tumor-infiltrating lymphocyte (TIL) therapies, and natural killer (NK) cell treatments, all aimed at enhancing the ability of the immune system to target and eliminate resistant tumor cells. Tissue engineering, particularly hydrogel-based delivery systems, offers the potential for localized treatment. These systems enable the controlled release of therapeutic agents or immune cells directly to the tumor site, supporting tissue regeneration and enhancing immune surveillance to reduce recurrence. Despite these advancements, challenges remain, including treatment resistance, the immunosuppressive tumor microenvironment, and high costs. Overcoming these barriers requires further innovation in drug delivery systems and a deeper understanding of tumor biology.
乳腺癌（BC）是女性中最常见的恶性肿瘤，也是全球癌症相关死亡的主要原因。尽管在早期检测和治疗方面已取得进展，但转移性乳腺癌（mBC）仍然是一种无法治愈的疾病。虽然现有治疗方法可以延长生存期并提高生活质量，但并不能提供彻底治愈。靶向治疗显著改善了治疗效果，特别是对于人表皮生长因子受体2（HER2）阳性和激素受体（HR）阳性（HR+）的乳腺癌亚型。关键创新包括抗体药物偶联物（ADC）和新一代内分泌疗法。ADC将单克隆抗体与细胞毒性药物结合，使药物能够靶向递送至肿瘤细胞，同时将全身毒性降至最低。免疫疗法正在成为治疗侵袭性亚型（如三阴性乳腺癌（TNBC））的一种有前景的方法。正在研究的策略包括嵌合抗原受体T细胞（CAR-T）疗法、肿瘤浸润淋巴细胞（TIL）疗法和自然杀伤（NK）细胞疗法，所有这些都旨在增强免疫系统靶向和消除耐药肿瘤细胞的能力。组织工程，特别是基于水凝胶的递送系统，为局部治疗提供了潜力。这些系统能够将治疗剂或免疫细胞直接可控地释放到肿瘤部位，支持组织再生并增强免疫监视以减少复发。尽管取得了这些进展，但挑战仍然存在，包括治疗耐药性、免疫抑制性肿瘤微环境和高成本。克服这些障碍需要药物递送系统的进一步创新以及对肿瘤生物学更深入的了解。
