晚期三阴性乳腺癌精准治疗的研究进展
Research Progress in Precision Treatment of Advanced Triple-Negative Breast Cancer
DOI: 10.12677/acm.2026.162662, PDF,   
作者: 陈 静, 尹树山*:南充市高坪区人民医院肿瘤中心,四川 南充;李青容:川北医学院附属医院检验科,四川 南充
关键词: 三阴性乳腺癌靶向治疗免疫治疗抗体偶联药物治疗Triple-Negative Breast Cancer Targeted-Therapy Immunotherapy Antibody-Drug Conjugate Therapy
摘要: 三阴性乳腺癌(Triple-Negative Breast Cancer, TNBC)是乳腺癌中最具侵袭性的一个亚型,其恶性程度高,易出现内脏转移和脑转移。目前系统治疗仍然以化疗为主。近年来,随着特殊靶点的发现及靶向、免疫和抗体偶联药物的发明,精准治疗药物被应用于晚期三阴性乳腺癌的治疗中,其具有特异性、高效性、安全性等特点,大幅度降低了传统化疗所造成的毒副反应,进一步改善了TNBC患者的预后。本文详细阐述TNBC的靶向、免疫以及抗偶联药物的研究进展,以期为临床治疗提供参考。
Abstract: Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer. It has a high degree of malignancy and is prone to visceral metastasis and brain metastasis. At present, systemic treatment still mainly relies on chemotherapy. In recent years, with the discovery of special targets and the invention of targeted, immune, and antibody-drug conjugates, precision therapeutic drugs have been applied in the treatment of advanced triple-negative breast cancer. They have the characteristics of specificity, high efficiency, and safety, significantly reducing the toxicity and side effects caused by traditional chemotherapy and further improving the prognosis of TNBC patients. This article elaborates in detail on the research progress of targeted, immune, and anti-conjugation drugs for TNBC, with the aim of providing a reference for clinical treatment.
文章引用:陈静, 尹树山, 李青容. 晚期三阴性乳腺癌精准治疗的研究进展[J]. 临床医学进展, 2026, 16(2): 2547-2553. https://doi.org/10.12677/acm.2026.162662

参考文献

[1] Siegel, R.L., Miller, K.D., Wagle, N.S. and Jemal, A. (2023) Cancer Statistics, 2023. CA: A Cancer Journal for Clinicians, 73, 17-48. [Google Scholar] [CrossRef] [PubMed]
[2] Jiang, Y.Z., Liu, Y., Xiao, Y., Hu, X., Jiang, L., Zuo, W., et al. (2021) Molecular Subtyping and Genomic Profiling Expand Precision Medicine in Refractory Metastatic Triple-Negative Breast Cancer: The FUTURE Trial. Cell Research, 31, 178-186. [Google Scholar] [CrossRef] [PubMed]
[3] Waterhouse, J.V., Holdich, A., Mina, F., Obeid, M., Joshi, K., Barrett, S., et al. (2025) Safety and Efficacy of Atezolizumab in Combination with Nab-Paclitaxel in Patients with PD-L1 Positive Metastatic or Locally Advanced Triple-Negative Breast Cancer: A UK-Wide Cancer Centre Experience. Clinical Oncology, 49, Article 103968. [Google Scholar] [CrossRef
[4] Khan, M., Du, K., Ai, M., Wang, B., Lin, J., Ren, A., et al. (2023) PD-L1 Expression as Biomarker of Efficacy of PD-1/PD-L1 Checkpoint Inhibitors in Metastatic Triple Negative Breast Cancer: A Systematic Review and Meta-Analysis. Frontiers in Immunology, 14, Article 1060308. [Google Scholar] [CrossRef] [PubMed]
[5] Latif, F., Bint Abdul Jabbar, H., Malik, H., Sadaf, H., Sarfraz, A., Sarfraz, Z., et al. (2022) Atezolizumab and Pembrolizumab in Triple-Negative Breast Cancer: A Meta-Analysis. Expert Review of Anticancer Therapy, 22, 229-235. [Google Scholar] [CrossRef] [PubMed]
[6] Winer, E.P., Lipatov, O., Im, S., Goncalves, A., Muñoz-Couselo, E., Lee, K.S., et al. (2021) Pembrolizumab versus Investigator-Choice Chemotherapy for Metastatic Triple-Negative Breast Cancer (KEYNOTE-119): A Randomised, Open-Label, Phase 3 Trial. The Lancet Oncology, 22, 499-511. [Google Scholar] [CrossRef] [PubMed]
[7] Miles, D., Gligorov, J., André, F., et al. (2021) Primary Results from IMpassion131, a Double-Blind, Placebo-Controlled, Randomised Phase III Trial of First-Line Paclitaxel with or without Atezolizumab for Unresectable Locally Advanced/Metastatic Triple-Negative Breast Cancer. Annals of Oncology, 32, 994-1004.
[8] Schmid, P., Lipatov, O., Im, S., Goncalves, A., Muñoz-Couselo, E., Lee, K.S., et al. (2023) Impact of Pembrolizumab versus Chemotherapy on Health-Related Quality of Life in Patients with Metastatic Triple-Negative Breast Cancer: Results from the Phase 3 Randomised KEYNOTE-119 Study. European Journal of Cancer, 195, Article 113393. [Google Scholar] [CrossRef] [PubMed]
[9] Emens, L.A., Adams, S., Barrios, C.H., Diéras, V., Iwata, H., Loi, S., et al. (2021) First-Line Atezolizumab Plus Nab-Paclitaxel for Unresectable, Locally Advanced, or Metastatic Triple-Negative Breast Cancer: Impassion130 Final Overall Survival Analysis. Annals of Oncology, 32, 983-993. [Google Scholar] [CrossRef] [PubMed]
[10] Im, S.A., Cortes, J., Cescon, D.W., Yusof, M.M., Iwata, H., Masuda, N., et al. (2024) Results from the Randomized KEYNOTE-355 Study of Pembrolizumab Plus Chemotherapy for Asian Patients with Advanced TNBC. npj Breast Cancer, 10, Article No. 79. [Google Scholar] [CrossRef] [PubMed]
[11] Denkert, C., von Minckwitz, G., Darb-Esfahani, S., Lederer, B., Heppner, B.I., Weber, K.E., et al. (2018) Tumour-Infiltrating Lymphocytes and Prognosis in Different Subtypes of Breast Cancer: A Pooled Analysis of 3771 Patients Treated with Neoadjuvant Therapy. The Lancet Oncology, 19, 40-50. [Google Scholar] [CrossRef] [PubMed]
[12] Li, Q., Liu, J., Zhang, Q., Ouyang, Q., Zhang, Y., Liu, Q., et al. (2024) The Anti-PD-L1/CTLA-4 Bispecific Antibody KN046 in Combination with Nab-Paclitaxel in First-Line Treatment of Metastatic Triple-Negative Breast Cancer: A Multicenter Phase II Trial. Nature Communications, 15, Article No. 1015. [Google Scholar] [CrossRef] [PubMed]
[13] Schettini, F., Venturini, S., Giuliano, M., Lambertini, M., Pinato, D.J., Onesti, C.E., et al. (2022) Multiple Bayesian Network Meta-Analyses to Establish Therapeutic Algorithms for Metastatic Triple Negative Breast Cancer. Cancer Treatment Reviews, 111, Article 102468. [Google Scholar] [CrossRef] [PubMed]
[14] Robson, M., Im, S.A., Senkus, E., Xu, B., Domchek, S.M., Masuda, N., et al. (2017) Olaparib for Metastatic Breast Cancer in Patients with a Germline BRCA Mutation. New England Journal of Medicine, 377, 523-533. [Google Scholar] [CrossRef] [PubMed]
[15] García-Saenz, J.Á., Rodríguez-Lescure, Á., Cruz, J., Albanell, J., Alba, E. and Llombart, A. (2025) Second-Line Treatment Options for Patients with Metastatic Triple-Negative Breast Cancer: A Review of the Clinical Evidence. Targeted Oncology, 20, 191-213. [Google Scholar] [CrossRef] [PubMed]
[16] Litton, J.K., Hurvitz, S.A., Mina, L.A., et al. (2020) Talazoparib versus Chemotherapy in Patients with Germline BRCA1/2-Mutated HER2-Negative Advanced Breast Cancer: Final Overall Survival Results from the EMBRACA Trial. Annals of Oncology, 31, 1526-1535. [Google Scholar] [CrossRef] [PubMed]
[17] Savill, K.M.Z., Ivanova, J., Asgarisabet, P., Falkenstein, A., Balanean, A., Niyazov, A., et al. (2023) Characteristics, Treatment, and Outcomes of Real-World Talazoparib-Treated Patients with Germline BRCA-Mutated Advanced HER2-Negative Breast Cancer. The Oncologist, 28, 414-424. [Google Scholar] [CrossRef] [PubMed]
[18] Heldin, C.H. (2013) Targeting the PDGF Signaling Pathway in Tumor Treatment. Cell Communication and Signaling, 11, Article No. 97. [Google Scholar] [CrossRef] [PubMed]
[19] Wang, J.Y., Xu, B.H., Ouyang, Q., Wang, Z., Zhang, Q., Ren, Y., et al. (2025) ETER901: A Randomized, Open-Label, Phase III Trial of Anlotinib in Combination with Anti-Pd-L1 Antibody Benmelstobart (TQB2450) versus Nab-Paclitaxel in First-Line Treatment of Recurrent or Metastatic Triple-Negative Breast Cancer. Journal of Clinical Oncology, 43, 1104-1104. [Google Scholar] [CrossRef
[20] Huang, W., Wang, C., Shen, Y., Chen, Q., Huang, Z., Liu, J., et al. (2024) A Real-World Study of the Effectiveness and Safety of Apatinib-Based Regimens in Metastatic Triple-Negative Breast Cancer. BMC Cancer, 24, Article No. 39. [Google Scholar] [CrossRef] [PubMed]
[21] Prasath, V., Boutrid, H., Wesolowski, R., Abdel-Rasoul, M., Timmers, C., Lustberg, M., et al. (2025) Phase II Study of MEK Inhibitor Trametinib Alone and in Combination with AKT Inhibitor GSK2141795/Uprosertib in Patients with Metastatic Triple Negative Breast Cancer. Breast Cancer Research and Treatment, 210, 179-189. [Google Scholar] [CrossRef] [PubMed]
[22] Dent, R., Oliveira, M., Isakoff, S.J., Im, S.A., et al. (2021) Final Results of the Double-Blind Placebo-Controlled Randomized Phase 2 LOTUS Trial of First-Line Ipatasertib Plus Paclitaxel for Inoperable Locally Advanced/Metastatic Triple-Negative Breast Cancer. Breast Cancer Research and Treatment, 189, 377-386.
[23] Batalini, F., Xiong, N., Tayob, N., Polak, M., Eismann, J., Cantley, L.C., et al. (2022) Phase 1b Clinical Trial with Alpelisib Plus Olaparib for Patients with Advanced Triple-Negative Breast Cancer. Clinical Cancer Research, 28, 1493-1499. [Google Scholar] [CrossRef] [PubMed]
[24] Tarantino, P., Hamilton, E., Tolaney, S.M., Cortes, J., Morganti, S., Ferraro, E., et al. (2020) HER2-Low Breast Cancer: Pathological and Clinical Landscape. Journal of Clinical Oncology, 38, 1951-1962. [Google Scholar] [CrossRef] [PubMed]
[25] Modi, S., Jacot, W., Yamashita, T., et al. (2022) Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer. The New England Journal of Medicine, 387, 9-20.
[26] Mosele, F., Deluche, E., Lusque, A., Le Bescond, L., Filleron, T., Pradat, Y., et al. (2023) Trastuzumab Deruxtecan in Metastatic Breast Cancer with Variable HER2 Expression: The Phase 2 DAISY Trial. Nature Medicine, 29, 2110-2120. [Google Scholar] [CrossRef] [PubMed]
[27] Bardia, A., Jhaveri, K., Kalinsky, K., Pernas, S., Tsurutani, J., Xu, B., et al. (2024) TROPION-Breast01: Datopotamab Deruxtecan vs Chemotherapy in Pre-Treated Inoperable or Metastatic HR+/HER2-Breast Cancer. Future Oncology, 20, 423-436. [Google Scholar] [CrossRef] [PubMed]
[28] Trerotola, M., Cantanelli, P., Guerra, E., Tripaldi, R., Aloisi, A.L., Bonasera, V., et al. (2013) Upregulation of Trop-2 Quantitatively Stimulates Human Cancer Growth. Oncogene, 32, 222-233. [Google Scholar] [CrossRef] [PubMed]
[29] Bardia, A., Rugo, H.S., Tolaney, S.M., Loirat, D., Punie, K., Oliveira, M., et al. (2024) Final Results from the Randomized Phase III ASCENT Clinical Trial in Metastatic Triple-Negative Breast Cancer and Association of Outcomes by Human Epidermal Growth Factor Receptor 2 and Trophoblast Cell Surface Antigen 2 Expression. Journal of Clinical Oncology, 42, 1738-1744. [Google Scholar] [CrossRef] [PubMed]
[30] Xu, B., Ma, F., Wang, T., Wang, S., Tong, Z., Li, W., et al. (2023) A Phase IIb, Single Arm, Multicenter Trial of Sacituzumab Govitecan in Chinese Patients with Metastatic Triple-Negative Breast Cancer Who Received at Least Two Prior Treatments. International Journal of Cancer, 152, 2134-2144. [Google Scholar] [CrossRef] [PubMed]
[31] Schmid, P., Wysocki, P.J., Ma, C.X., Park, Y.H., Fernandes, R., Lord, S., et al. (2023) 379MO Datopotamab Deruxtecan (Dato-DXd) + Durvalumab (D) as First-Line (1L) Treatment for Unresectable Locally Advanced/Metastatic Triple-Negative Breast Cancer (a/mTNBC): Updated Results from BEGONIA, a Phase Ib/II Study. Annals of Oncology, 34, S337. [Google Scholar] [CrossRef
[32] Xu, B., Yin, Y., Fan, Y., Ouyang, Q., Song, L., Wang, X., et al. (2024) Sacituzumab Tirumotecan (SKB264/MK-2870) in Patients (pts) with Previously Treated Locally Recurrent or Metastatic Triple-Negative Breast Cancer (TNBC): Results from the Phase III Optitrop-Breast01 Study. Journal of Clinical Oncology, 42, 104-104. [Google Scholar] [CrossRef
[33] Corti, C., Venetis, K., Sajjadi, E., Zattoni, L., Curigliano, G. and Fusco, N. (2022) CAR-T Cell Therapy for Triple-Negative Breast Cancer and Other Solid Tumors: Preclinical and Clinical Progress. Expert Opinion on Investigational Drugs, 31, 593-605. [Google Scholar] [CrossRef] [PubMed]
[34] Krop, I.E., Masuda, N., Mukohara, T., Takahashi, S., Nakayama, T., Inoue, K., et al. (2023) Patritumab Deruxtecan (HER3-DXd), a Human Epidermal Growth Factor Receptor 3-Directed Antibody-Drug Conjugate, in Patients with Previously Treated Human Epidermal Growth Factor Receptor 3-Expressing Metastatic Breast Cancer: A Multicenter, Phase I/II Trial. Journal of Clinical Oncology, 41, 5550-5560. [Google Scholar] [CrossRef] [PubMed]