ABSTRACT

Introduction

Triple negative breast cancer, defined by a lack of estrogen receptor, progesterone receptor, or human epidermal growth factor2, accounts for approximately 15% of breast cancer patients. Treatment options have historically been limited to chemotherapy, which has significant toxicity and a suboptimal impact on the five-year relapse rate and survival.

Areas covered

Transcriptomic analyses reveal that TNBC is biologically heterogenous. Predictive biomarkers based on the distinct biology of the different subtypes of TNBC should identify patients that will derive the greatest benefit from a specifically targeted therapeutic agent. Two biomarker-driven treatments have recently been approved: poly-ADP ribose polymerase inhibitors for patients with germline BRCA mutations and atezolizumab in combination with nab-paclitaxel for patients expressing PD-L1 on tumor-infiltrating immune cells.

Expert opinion

Identifying informative predictive biomarkers is critical for the optimal development of targeted drugs for TNBC. Some targeted agents, such as the antibody-drug conjugate sacituzumab govitecan-hziy and the precision medicines capivasertib and ipatisertib, have already shown promising results in early clinical trials, and the results of definitive phase 3 trials are eagerly awaited. Additionally, testing novel immunotherapies and other targeted agents in earlier stages of disease, particularly the neoadjuvant setting, is a high priority.

中文翻译：

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目前和新兴的三阴性乳腺癌生物疗法

摘要

介绍

由缺乏雌激素受体、孕激素受体或人表皮生长因子2定义的三阴性乳腺癌约占乳腺癌患者的 15%。历史上，治疗选择仅限于化疗，它具有显着的毒性，对五年复发率和生存率的影响并不理想。

涵盖的领域

转录组学分析表明 TNBC 在生物学上是异质的。基于 TNBC 不同亚型的不同生物学特性的预测性生物标志物应确定将从特异性靶向治疗剂中获得最大益处的患者。最近批准了两种生物标志物驱动的治疗方法：用于具有生殖系BRCA突变的患者的聚 ADP 核糖聚合酶抑制剂和用于在肿瘤浸润免疫细胞上表达 PD-L1 的患者的atezolizumab 联合nab紫杉醇。

专家意见

识别信息丰富的预测性生物标志物对于优化 TNBC 靶向药物的开发至关重要。一些靶向药物，如抗体药物偶联物 sacituzumab govitecan-hziy 和精准药物 capivasertib 和 ipatisertib，已经在早期临床试验中显示出可喜的结果，并热切期待最终的 3 期试验结果。此外，在疾病的早期阶段测试新的免疫疗法和其他靶向药物，特别是新辅助治疗，是一个高度优先事项。