肿瘤细胞治疗研究
英文原题:Unlocking New Frontiers in Breast Cancer: The Role of the Tumor Microenvironment, Cutting-Edge Therapies, and Immunotherapy.
Unlocking New Frontiers in Breast Cancer: The Role of the Tumor Microenvironment, Cutting-Edge Therapies, and Immunotherapy.
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乳腺癌(BC)仍然是全球女性中最常见的恶性肿瘤,由于筛查、诊断和治疗可及性的差异,不同地区的发病率和死亡率各不相同。分子分型重新定义了BC的管理,将肿瘤分为luminal A型、luminal B型、人表皮生长因子受体2(HER2)富集型和三阴性乳腺癌(TNBC),每种类型具有不同的预后和治疗意义。肿瘤微环境(TME)研究的进展凸显了其在癌症进展、免疫逃逸和治疗耐药中的关键作用,强调了TIL(肿瘤浸润淋巴细胞)、NK 细胞和巨噬细胞在影响BC结局中的重要性。传统疗法,包括化疗、内分泌治疗以及靶向治疗如细胞周期蛋白依赖性激酶4和6(CDK4/6)和磷脂酰肌醇-4,5-二磷酸3-激酶(PI3K)抑制剂,不断演进以克服耐药机制。免疫治疗,特别是靶向程序性细胞死亡蛋白1(PD1)、程序性细胞死亡配体1(PD-L1)和细胞毒性T淋巴细胞相关抗原4(CTLA4)的免疫检查点抑制剂,已显示出临床获益,尤其是在TNBC中。
此外,新型策略,包括CAR-T 细胞疗法和癌症疫苗,正作为有前景的治疗途径崭露头角。本综述对BC流行病学、分子亚型、TME相互作用及前沿治疗策略进行了全面分析,强调需要个性化、基于免疫的方法以提高治疗效果和患者结局。
Breast cancer (BC) remains the most prevalent malignancy among women worldwide, with incidence and mortality rates varying across regions due to disparities in screening, diagnosis, and treatment accessibility. Molecular classification has redefined BC management, categorizing tumors into luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and triple-negative breast cancer (TNBC), each with distinct prognostic and therapeutic implications. Advances in tumor microenvironment (TME) research highlight its critical role in cancer progression, immune evasion, and treatment resistance, underscoring the importance of tumor-infiltrating lymphocytes, natural killer cells, and macrophages in shaping BC outcomes.
Traditional therapies, including chemotherapy, endocrine therapy, and targeted treatments such as cyclin-dependent kinase 4 and 6 (CDK4/6) and phosphatidylinositol-4,5-biphosphate 3-kinase (PI3K) inhibitors, continue to evolve to overcome resistance mechanisms. Immunotherapy, particularly immune checkpoint inhibitors targeting programmed cell death protein 1 (PD1), programmed cell death ligand 1 (PD-L1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA4), has demonstrated clinical benefits, especially in TNBC.
Additionally, novel strategies, including chimeric antigen receptor T-cell therapy and cancer vaccines, are emerging as promising therapeutic avenues. This review provides a comprehensive analysis of BC epidemiology, molecular subtypes, TME interactions, and cutting-edge therapeutic strategies, emphasizing the need for personalized, immune-based approaches to enhance treatment efficacy and patient outcomes.
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