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乳腺癌管理的新策略:从治疗到长期缓解

英文原题:Novel strategies in breast cancer management: From treatment to long-term remission.

PubMed 2025/04/03(内容时间) Crit Rev Oncol Hematol Q1 · IF 6.2(JCR 2025)

研究概要

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之一。

中文摘要

乳腺癌(BC)是女性最常见的恶性肿瘤,也是全球癌症相关死亡的主要原因之一。虽然早期检测和治疗已有进步,转移性乳腺癌(mBC)仍无法治愈。现有治疗可延长生存并改善生活质量,但不能根治。靶向治疗显著改善了结局,尤其是人表皮生长因子受体 2(HER2)阳性和激素受体(HR)阳性亚型。关键创新包括抗体-药物偶联物(ADC)和新一代内分泌治疗。ADC 将单克隆抗体与细胞毒药物结合,能够靶向递送至肿瘤细胞,同时尽量减少全身毒性。免疫治疗正成为侵袭性亚型(如三阴性乳腺癌[TNBC])的一种有前景方法。正在研究的策略包括CAR-T 细胞疗法、TIL(肿瘤浸润淋巴细胞)疗法和自然杀伤(NK)细胞疗法,均旨在增强免疫系统靶向并清除耐药肿瘤细胞的能力。组织工程,尤其是水凝胶递送系统,有望实现局部治疗。这些系统可将治疗药物或免疫细胞可控地释放至肿瘤部位,支持组织再生并增强免疫监视,从而减少复发。尽管取得这些进展,治疗耐药、免疫抑制性肿瘤微环境和高成本等挑战仍然存在。克服这些障碍需要进一步创新药物递送系统并深入理解肿瘤生物学。

展开英文摘要原文

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.

论文信息

作者
Habibi S、Bahramian S、Zare Jalise S、Mehri S、Ababzadeh S、Kavianpour M
第一作者单位
Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.Iran
通讯作者单位
Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Qom University of Medical Sciences, Qom, Iran; Cellular and Molecular Research Center, Qom University of Medical Sciences, Qom, Iran. Electronic address: Kavianpour.maria@gmail.com.Iran
文献类型
综述
期刊
Critical reviews in oncology/hematology2025 Jul
原文标识
PubMed 40187709 · DOI 10.1016/j.critrevonc.2025.104715