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三阴性乳腺癌发病率上升:突破与未来展望

Triple-Negative Breast Cancer on the Rise: Breakthroughs and Beyond.

作者信息

Agelidis Alex, Ter-Zakarian Anna, Jaloudi Mohammed

机构信息

Scripps Cancer Center, Scripps Health, La Jolla, California, USA.

Scripps Translational Research Institute, Scripps Research, La Jolla, California, USA.

出版信息

Breast Cancer (Dove Med Press). 2025 Jun 26;17:523-529. doi: 10.2147/BCTT.S516125. eCollection 2025.

Abstract

Triple-negative breast cancer (TNBC) represents a particularly aggressive and heterogeneous subtype of breast cancer, associated with poor prognosis and limited treatment options. This review delves into the rising incidence of TNBC, particularly among younger women, and explores the significant demographic disparities that contribute to variations in incidence, treatment access and survival outcomes. We provide a discussion of TNBC's molecular and genetic landscape, including key pathways revolving around TP53, BRCA1/2 mutations, and PI3K/AKT signaling, which have informed the development of targeted therapies. Recent practice-changing studies are highlighted, which have resulted in the integration of immune checkpoint inhibitors in both early-stage and metastatic settings, the application of PARP inhibitors for BRCA-mutated TNBC and the introduction of antibody-drug conjugates as valuable new therapeutic options. We also review the role of neoadjuvant chemotherapy, novel biomarkers such as tumor-infiltrating lymphocytes, and advancements in diagnostic tools, including machine learning-based imaging and spatial transcriptomics, which are all driving shifts towards personalized approaches. This review synthesizes emerging research and major changes in clinical practice to provide a concise overview of the recent innovations and upcoming trends in TNBC diagnosis and therapy.

摘要

三阴性乳腺癌(TNBC)是一种侵袭性特别强且异质性的乳腺癌亚型,预后较差且治疗选择有限。本综述深入探讨了TNBC发病率的上升情况,尤其是在年轻女性中的发病率上升情况,并探讨了导致发病率、治疗可及性和生存结果存在差异的显著人口统计学差异。我们讨论了TNBC的分子和遗传格局,包括围绕TP53、BRCA1/2突变以及PI3K/AKT信号传导的关键通路,这些通路为靶向治疗的发展提供了依据。重点介绍了近期改变实践的研究,这些研究导致免疫检查点抑制剂在早期和转移性TNBC治疗中的应用、PARP抑制剂在BRCA突变型TNBC中的应用以及抗体药物偶联物作为有价值的新治疗选择的引入。我们还回顾了新辅助化疗的作用、肿瘤浸润淋巴细胞等新型生物标志物以及诊断工具的进展,包括基于机器学习的成像和空间转录组学,这些都推动了向个性化治疗方法的转变。本综述综合了新兴研究和临床实践中的重大变化,以简要概述TNBC诊断和治疗的近期创新和未来趋势。

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