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HER2阳性和HER2阴性乳腺癌的全面进展:揭示分子机制并探索前沿靶向治疗以改善患者预后。

Comprehensive advances in HER2-positive and HER2-negative breast cancer: unveiling molecular mechanisms and exploring cutting-edge targeted therapies for enhanced patient outcomes.

作者信息

Sood Nayan, Maurya Rashmi, Gautam Shreastha, Patel Preeti, Das Gupta Ghanshyam, Das Kurmi Balak

机构信息

Department of Pharmaceutics, ISF College of Pharmacy, GT Road, Moga, 142001, Punjab, India.

Department of Pharmaceutical Quality Assurance, ISF College of Pharmacy, GT Road, Moga, 142001, Punjab, India.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2025 May 29. doi: 10.1007/s00210-025-04204-w.

Abstract

The human epidermal growth factor receptor (HER2), part of the tyrosine kinase family, serves as a key therapeutic target for patients with breast cancer, particularly those with HER2 overexpression. HER2 is overexpressed or amplified in approximately 15-20% of breast cancers. It includes HER1, HER2, HER3, and HER4, which progress the growth of cancerous cells. Key signaling pathways involved in HER2-driven breast cancer progression include the MAPK and mTOR pathways, which activate a cascade of factors that promote DNA synthesis and cell growth. A crucial process in HER2 cancer development is HER2 dimerization, which forms a functional oncogenic unit and is followed crucially by HER2:HER3 heterodimerization that leads to downstream signaling pathways. Alterations in the HER2 in solid tumors and ERBB2 gene mutations have led to advancements and implantation of precision-targeted approaches, as well as to combat the issues from the traditional approaches of targeting. In this review, we have thoroughly discussed different HER2-targeting therapies, which include monoclonal antibodies, antibody-drug conjugates, tyrosine kinase inhibitors, poly (ADP-ribose) polymerase inhibitors, CDK4/6 inhibitors, molecular probes targeting by PET/CT imaging, cancer vaccines, and cell therapies like CART-T and CAR-M cell therapy. Some of these targeted therapies have shown effectiveness in managing HER2-positive breast cancer and promoting tumor regression, while some remain under investigation for their potential benefits.

摘要

人表皮生长因子受体(HER2)是酪氨酸激酶家族的一部分,是乳腺癌患者,尤其是HER2过表达患者的关键治疗靶点。在大约15%-20%的乳腺癌中,HER2过表达或扩增。它包括HER1、HER2、HER3和HER4,这些受体促进癌细胞的生长。HER2驱动的乳腺癌进展所涉及的关键信号通路包括MAPK和mTOR通路,它们激活一系列促进DNA合成和细胞生长的因子。HER2癌症发展中的一个关键过程是HER2二聚化,它形成一个功能性致癌单元,随后至关重要的是HER2:HER3异二聚化,这会导致下游信号通路。实体瘤中HER2的改变和ERBB2基因突变推动了精准靶向方法的发展和应用,同时也解决了传统靶向方法存在的问题。在本综述中,我们全面讨论了不同的HER2靶向治疗方法,包括单克隆抗体、抗体药物偶联物、酪氨酸激酶抑制剂、聚(ADP-核糖)聚合酶抑制剂、CDK4/6抑制剂、PET/CT成像靶向分子探针、癌症疫苗以及CART-T和CAR-M细胞疗法等细胞治疗。其中一些靶向治疗方法已显示出在治疗HER2阳性乳腺癌和促进肿瘤消退方面的有效性,而一些仍在研究其潜在益处。

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