Important research progress in clinical practice for advanced breast cancer in 2023
张思源 1江泽飞1
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作者信息
1. 解放军总医院第五医学中心肿瘤医学部,北京 100071
折叠
摘要
晚期乳腺癌的综合诊疗已进入"精准分类、精确分层"时代,并迈向个体化精准医学之路.2023年晚期乳腺癌不同分子分型研究领域取得了多项突破性进展,其研究结果影响临床指南,改变临床实践.激素受体阳性晚期乳腺癌的研究重点在于细胞周期蛋白依赖性激酶4和6(cyclin-dependent kinase 4 and 6,CDK4/6)抑制剂治疗失败患者的治疗选择.人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)低表达晚期乳腺癌已成为一个新兴治疗方向,而T-DXd是其重要的治疗选择.PHILA研究结果的公布,开启了HER2阳性晚期乳腺癌一线治疗的新纪元.同时T-DXd已成为临床治疗实践中酪氨酸激酶抑制剂治疗失败后的首选.晚期三阴性乳腺癌(triple-negative breast cancer,TNBC)中免疫治疗和靶向治疗相关研究也如火如荼,TORCHILIGHT研究、BEGONIA研究等取得了阳性结果.与此同时,探索TNBC精准治疗的"复旦分型"的系列临床研究也在持续进行中,有望改变目前的治疗模式.本文对2023年晚期乳腺癌的重大临床研究进展按照不同分子分型进行梳理和总结,以期更好地为临床治疗提供参考和指导.
Abstract
The comprehensive diagnosis and treatment of advanced breast cancer has entered the era of"accurate classification and precise stratification",and is moving towards the road of personalized precision medicine.In 2023,significant breakthroughs have been achieved in the research on different molecular classifications of advanced breast cancer,influencing clinical guidelines and transforming clinical practice.The primary focus of research for hormone receptor positive advanced breast cancer lies in selecting appropriate treatments for patients who have failed cyclin-dependent kinase 4 and 6(CDK4/6)inhibitors.Advanced breast cancer with low human epidermal growth factor receptor 2(HER2)expression has emerged as a promising treatment direction,with T-DXd being an important therapeutic option.With the release of results from the PHILA study,a new era has begun for first-line treatment of HER2-positive advanced breast cancer.Simultaneously,T-DXd has become the preferred choice in clinical practice following tyrosine kinase inhibitor failure.Research related to immune and targeted therapy for advanced triple-negative breast cancer(TNBC)is also progressing rapidly,yielding positive outcomes in studies such as TORCHILIGHT and BEGONIA.Additionally,ongoing clinical studies on precision treatment based on the"Fudan classification"for TNBC are expected to revolutionize current treatment approaches.This paper summarized major advancements in clinical research on advanced breast cancer in 2023 according to various molecular classifications,aiming to provide improved reference and guidance for clinical management.
关键词
晚期乳腺癌/临床研究/研究进展
Key words
Advanced breast cancer/Clinical study/Research progress
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