抗体药物治疗在乳腺癌中的进展
Progress of Antibody Drug Therapy in Breast Cancer
摘要: 乳腺癌作为女性高发恶性肿瘤，传统治疗存在副作用大、复发率高等局限性。抗体药物凭借高特异性和低毒性，成为乳腺癌治疗的重要方向，尤其是靶向HER2阳性亚型的单克隆抗体(如曲妥珠单抗)及抗体药物偶联物(ADCs)的进展显著改善了患者预后。本文综述了国内外研究现状，国内聚焦于ADCs的临床价值、分子分型指导的精准治疗及生物标志物探索(如HER2低表达、Trop-2靶点)，强调戈沙妥珠单抗等药物在三阴性乳腺癌中的突破；国外则在ADCs作用机制、技术创新(如纳米颗粒载药)及联合疗法(ADCs与免疫检查点抑制剂)方面领先，同时通过液体活检和个体化治疗优化临床决策。尽管抗体药物提升了疗效，耐药性、不良反应及疗效异质性仍是主要挑战。未来需深化耐药机制研究，优化联合治疗策略(如免疫联合、多靶点抑制)，并推动基于生物标志物的个体化精准治疗，为乳腺癌患者提供更高效、安全的治疗方案。
Abstract: Breast cancer is a highly prevalent malignant tumor among women. Traditional treatments have limitations such as significant side effects and a high recurrence rate. Antibody drugs, with their high specificity and low toxicity, have become an important direction in the treatment of breast cancer. In particular, the progress of monoclonal antibodies targeting HER2-positive subtypes (such as trastuzumab) and antibody-drug conjugates (ADCs) has significantly improved the prognosis of patients. This article reviews the research status at home and abroad. Domestic research focuses on the clinical value of ADCs, precision treatment guided by molecular typing, and the exploration of biomarkers (such as HER2 low expression and Trop-2 target), emphasizing the breakthroughs of drugs like sacituzumab govitecan in triple-negative breast cancer. Abroad, it leads in the mechanism of action of ADCs, technological innovation (such as drug loading with nanoparticles), and combination therapies (ADCs combined with immune checkpoint inhibitors). At the same time, clinical decisions are optimized through liquid biopsy and personalized treatment. Although antibody drugs have improved the therapeutic effect, drug resistance, adverse reactions, and heterogeneity of efficacy remain the main challenges. In the future, it is necessary to deepen the research on the mechanism of drug resistance, optimize combination treatment strategies (such as immune combination and multi-target inhibition), and promote personalized precision treatment based on biomarkers to provide more efficient and safe treatment options for breast cancer patients.
文章引用：刘紫莹. 抗体药物治疗在乳腺癌中的进展[J]. 临床医学进展, 2025, 15(5): 1694-1702. https://doi.org/10.12677/acm.2025.1551545

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