三阳性乳腺癌治疗策略研究进展
Research Progress in Therapeutic Strategies for Triple-Positive Breast Cancer
DOI: 10.12677/acm.2026.1631202, PDF,   
作者: 王 今, 秦 双*:河南医药大学第一附属医院甲状腺乳腺血管外科,河南 新乡
关键词: 三阳性乳腺癌HER2靶向治疗内分泌治疗精准治疗Triple-Positive Breast Cancer HER2-Targeted Therapy Endocrine Therapy Precision Treatment
摘要: 三阳性乳腺癌(Triple-Positive Breast Cancer, TPBC)是一类同时表达人表皮生长因子受体2 (HER2)、雌激素受体(ER)和孕激素受体(PR)的特殊乳腺癌亚型,约占所有乳腺癌的10%~15%。其生物学行为兼具HER2阳性乳腺癌的侵袭性和激素受体阳性乳腺癌的内分泌依赖性,且存在HER2与ER通路的复杂交叉对话,导致治疗响应异质性显著,临床管理面临独特挑战。本文系统综述了TPBC的生物学特征与分子机制,详细阐述了当前针对HER2靶向治疗、内分泌治疗及联合治疗的临床研究证据,探讨了新型治疗策略的研发进展,并对未来精准治疗方向进行展望,旨在为TPBC的临床实践和研究提供全面参考。
Abstract: Triple-positive breast cancer (TPBC) is a special subtype of breast cancer with co-expression of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR), accounting for approximately 10%~15% of all breast cancer cases. Its biological behavior combines the invasiveness of HER2-positive breast cancer and the endocrine dependence of hormone receptor-positive breast cancer, accompanied by complex crosstalk between the HER2 and ER signaling pathways. This results in significant heterogeneity in treatment response and poses unique challenges for clinical management. This paper systematically reviews the biological characteristics and molecular mechanisms of TPBC, elaborates on the current clinical evidence for HER2-targeted therapy, endocrine therapy and combination therapy, explores the research and development progress of novel therapeutic strategies, and looks forward to the future direction of precision treatment. It aims to provide a comprehensive reference for the clinical practice and research of TPBC.
文章引用:王今, 秦双. 三阳性乳腺癌治疗策略研究进展[J]. 临床医学进展, 2026, 16(3): 3918-3927. https://doi.org/10.12677/acm.2026.1631202

参考文献

[1] Choong, G.M., Cullen, G.D. and O’Sullivan, C.C. (2020) Evolving Standards of Care and New Challenges in the Management of HER2-Positive Breast Cancer. CA: A Cancer Journal for Clinicians, 70, 355-374. [Google Scholar] [CrossRef] [PubMed]
[2] Niu, N., Qiu, F., Xu, Q., He, G., Gu, X., Guo, W., et al. (2022) A Multicentre Single Arm Phase 2 Trial of Neoadjuvant Pyrotinib and Letrozole Plus Dalpiciclib for Triple-Positive Breast Cancer. Nature Communications, 13, Article No. 7043. [Google Scholar] [CrossRef] [PubMed]
[3] Blanter, J., Baldwin, E., Patel, R., Sheng, T. and Tiersten, A. (2024) Patterns in Use and Tolerance of Adjuvant Neratinib in Patients with Hormone Receptor (HR)-Positive, HER2-Positive Early-Stage Breast Cancer. Breast Cancer Research and Treatment, 208, 461-466. [Google Scholar] [CrossRef] [PubMed]
[4] Chaubal, R., Talker, E., Chitra, J., Kadam, R., Gardi, N., Ursekar, R., et al. (2025) Genomic Landscape of Hormone Therapy-Resistant HR-Positive, HER2-Negative Breast Cancer. Breast Cancer Research and Treatment, 213, 247-259. [Google Scholar] [CrossRef] [PubMed]
[5] Sanli, A.N., Turan, B., Tekcan Sanli, D.E., Karaca, I., Altundag, M.K. and Aydogan, F. (2025) Neoadjuvant Response Stratification Based on Complete, Partial, and No Response in HR-Positive/HER2-Positive Breast Cancer. Breast Cancer Research and Treatment, 214, 247-264. [Google Scholar] [CrossRef
[6] Wolff, A.C., Hammond, M.E.H., Allison, K.H., Harvey, B.E., Mangu, P.B., Bartlett, J.M.S., et al. (2018) Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. Archives of Pathology & Laboratory Medicine, 142, 1364-1382. [Google Scholar] [CrossRef] [PubMed]
[7] Zhao, S., Liu, X., Jin, X., Ma, D., Xiao, Y., Shao, Z., et al. (2019) Molecular Portraits and Trastuzumab Responsiveness of Estrogen Receptor-Positive, Progesterone Receptor-Positive, and HER2-Positive Breast Cancer. Theranostics, 9, 4935-4945. [Google Scholar] [CrossRef] [PubMed]
[8] Gianni, L., Pienkowski, T., Im, Y., Roman, L., Tseng, L., Liu, M., et al. (2012) Efficacy and Safety of Neoadjuvant Pertuzumab and Trastuzumab in Women with Locally Advanced, Inflammatory, or Early HER2-Positive Breast Cancer (NeoSphere): A Randomised Multicentre, Open-Label, Phase 2 Trial. The Lancet Oncology, 13, 25-32. [Google Scholar] [CrossRef] [PubMed]
[9] Giuliano, M., Trivedi, M.V. and Schiff, R. (2013) Bidirectional Crosstalk between the Estrogen Receptor and Human Epidermal Growth Factor Receptor 2 Signaling Pathways in Breast Cancer: Molecular Basis and Clinical Implications. Breast Care, 8, 256-262. [Google Scholar] [CrossRef] [PubMed]
[10] Velloso, F., Bianco, A., Farias, J.O., et al. (2017) The Crossroads of Breast Cancer Progression: Insights into the Modulation of Major Signaling Pathways. OncoTargets and Therapy, 10, 5491-5524. [Google Scholar] [CrossRef] [PubMed]
[11] Arteaga, C.L., Sliwkowski, M.X., Osborne, C.K., Perez, E.A., Puglisi, F. and Gianni, L. (2011) Treatment of HER2-Positive Breast Cancer: Current Status and Future Perspectives. Nature Reviews Clinical Oncology, 9, 16-32. [Google Scholar] [CrossRef] [PubMed]
[12] Pietras, R.J., Arboleda, J., Reese, D.M., et al. (1995) HER-2 Tyrosine Kinase Pathway Targets Estrogen Receptor and Promotes Hormone-Independent Growth in Human Breast Cancer Cells. Oncogene, 10, 2435-2446.
[13] Osborne, C.K., Bardou, V., Hopp, T.A., Chamness, G.C., Hilsenbeck, S.G., Fuqua, S.A.W., et al. (2003) Role of the Estrogen Receptor Coactivator AIB1 (SRC-3) and HER-2/Neu in Tamoxifen Resistance in Breast Cancer. JNCI Journal of the National Cancer Institute, 95, 353-361. [Google Scholar] [CrossRef] [PubMed]
[14] Hurtado, A., Holmes, K.A., Geistlinger, T.R., Hutcheson, I.R., Nicholson, R.I., Brown, M., et al. (2008) Regulation of ERBB2 by Oestrogen Receptor-Pax2 Determines Response to Tamoxifen. Nature, 456, 663-666. [Google Scholar] [CrossRef] [PubMed]
[15] Shou, J., Massarweh, S., Osborne, C.K., Wakeling, A.E., Ali, S., Weiss, H., et al. (2004) Mechanisms of Tamoxifen Resistance: Increased Estrogen Receptor-HER2/Neu Cross-Talk in Er/HER2-Positive Breast Cancer. JNCI Journal of the National Cancer Institute, 96, 926-935. [Google Scholar] [CrossRef] [PubMed]
[16] Shao, Z., Pang, D., Yang, H., Li, W., Wang, S., Cui, S., et al. (2020) Efficacy, Safety, and Tolerability of Pertuzumab, Trastuzumab, and Docetaxel for Patients with Early or Locally Advanced ERBB2-Positive Breast Cancer in Asia: The PEONY Phase 3 Randomized Clinical Trial. JAMA Oncology, 6, e193692. [Google Scholar] [CrossRef] [PubMed]
[17] Cortés, J., Kim, S., Chung, W., Im, S., Park, Y.H., Hegg, R., et al. (2022) Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer. New England Journal of Medicine, 386, 1143-1154. [Google Scholar] [CrossRef] [PubMed]
[18] Gianni, L., Bisagni, G., Colleoni, M., Del Mastro, L., Zamagni, C., Mansutti, M., et al. (2018) Neoadjuvant Treatment with Trastuzumab and Pertuzumab Plus Palbociclib and Fulvestrant in HER2-Positive, Er-Positive Breast Cancer (NA-PHER2): An Exploratory, Open-Label, Phase 2 Study. The Lancet Oncology, 19, 249-256. [Google Scholar] [CrossRef] [PubMed]
[19] Symmans, W.F., Yau, C., Chen, Y., Balassanian, R., Klein, M.E., Pusztai, L., et al. (2021) Assessment of Residual Cancer Burden and Event-Free Survival in Neoadjuvant Treatment for High-Risk Breast Cancer: An Analysis of Data from the I-SPY2 Randomized Clinical Trial. JAMA Oncology, 7, 1654-1663. [Google Scholar] [CrossRef] [PubMed]
[20] von Minckwitz, G., Untch, M., Blohmer, J., Costa, S.D., Eidtmann, H., Fasching, P.A., et al. (2012) Definition and Impact of Pathologic Complete Response on Prognosis after Neoadjuvant Chemotherapy in Various Intrinsic Breast Cancer Subtypes. Journal of Clinical Oncology, 30, 1796-1804. [Google Scholar] [CrossRef] [PubMed]
[21] Dowsett, M., Nielsen, T.O., A’Hern, R., Bartlett, J., Coombes, R.C., Cuzick, J., et al. (2011) Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group. JNCI Journal of the National Cancer Institute, 103, 1656-1664. [Google Scholar] [CrossRef] [PubMed]
[22] Swain, S.M., Miles, D., Kim, S., Im, Y., Im, S., Semiglazov, V., et al. (2020) Pertuzumab, Trastuzumab, and Docetaxel for HER2-Positive Metastatic Breast Cancer (CLEOPATRA): End-of-Study Results from a Double-Blind, Randomised, Placebo-Controlled, Phase 3 Study. The Lancet Oncology, 21, 519-530. [Google Scholar] [CrossRef] [PubMed]
[23] Loft, M., Lok, S.W., De Boer, R.H., Malik, L., Greenberg, S., Yeo, B., et al. (2020) Addition of Endocrine Therapy to Dual Anti-HER2 Targeted Therapy in Initial Treatment of HER2+/HR+ Metastatic Breast Cancer. Journal of Clinical Oncology, 38, 1038-1038. [Google Scholar] [CrossRef
[24] Rimawi, M., Ferrero, J., de la Haba-Rodriguez, J., Poole, C., De Placido, S., Osborne, C.K., et al. (2018) First-Line Trastuzumab Plus an Aromatase Inhibitor, with or without Pertuzumab, in Human Epidermal Growth Factor Receptor 2-Positive and Hormone Receptor-Positive Metastatic or Locally Advanced Breast Cancer (PERTAIN): A Randomized, Open-Label Phase II Trial. Journal of Clinical Oncology, 36, 2826-2835. [Google Scholar] [CrossRef] [PubMed]
[25] Arpino, G., de la Haba-Rodríguez, J., Ferrero, J.M., et al. (2023) Pertuzumab, Trastuzumab, and an Aromatase Inhibitor for HER2-Positive and Hormone Receptor-Positive Metastatic/Locally Advanced Breast Cancer: PERTAIN Final Analysis. Clin Cancer Research, 29, 1468-1476.
[26] Kaufman, B., Mackey, J.R., Clemens, M.R., Bapsy, P.P., Vaid, A., Wardley, A., et al. (2009) Trastuzumab Plus Anastrozole versus Anastrozole Alone for the Treatment of Postmenopausal Women with Human Epidermal Growth Factor Receptor 2-Positive, Hormone Receptor-Positive Metastatic Breast Cancer: Results from the Randomized Phase III TAnDEM Study. Journal of Clinical Oncology, 27, 5529-5537. [Google Scholar] [CrossRef] [PubMed]
[27] Johnston, S.R.D., Hegg, R., Im, S., Park, I.H., Burdaeva, O., Kurteva, G., et al. (2021) Phase III, Randomized Study of Dual Human Epidermal Growth Factor Receptor 2 (HER2) Blockade with Lapatinib Plus Trastuzumab in Combination with an Aromatase Inhibitor in Postmenopausal Women with HER2-Positive, Hormone Receptor-Positive Metastatic Breast Cancer: Updated Results of Alternative. Journal of Clinical Oncology, 39, 79-89. [Google Scholar] [CrossRef] [PubMed]
[28] Johnston, S., Pippen, J., Pivot, X., Lichinitser, M., Sadeghi, S., Dieras, V., et al. (2009) Lapatinib Combined with Letrozole versus Letrozole and Placebo as First-Line Therapy for Postmenopausal Hormone Receptor-POsitive Metastatic Breast Cancer. Journal of Clinical Oncology, 27, 5538-5546. [Google Scholar] [CrossRef] [PubMed]
[29] Perez, E.A., Barrios, C., Eiermann, W., Toi, M., Im, Y., Conte, P., et al. (2019) Trastuzumab Emtansine with or without Pertuzumab versus Trastuzumab with Taxane for Human Epidermal Growth Factor Receptor 2-Positive Advanced Breast Cancer: Final Results from Marianne. Cancer, 125, 3974-3984. [Google Scholar] [CrossRef] [PubMed]
[30] Tolaney, S.M., Barroso-Sousa, R., Jiang, Z., Park, Y.H., Rimawi, M., Saura Manich, C., et al. (2021) 328TiP Phase III Study of Trastuzumab Deruxtecan (T-DXd) with or without Pertuzumab vs a Taxane, Trastuzumab and Pertuzumab in First-Line (1L), Human Epidermal Growth Factor Receptor 2-Positive (HER2+) Metastatic Breast Cancer (mBC): Destiny-Breast09. Annals of Oncology, 32, S507-S508. [Google Scholar] [CrossRef
[31] Verma, S., Miles, D., Gianni, L., Krop, I.E., Welslau, M., Baselga, J., et al. (2012) Trastuzumab Emtansine for HER2-Positive Advanced Breast Cancer. New England Journal of Medicine, 367, 1783-1791. [Google Scholar] [CrossRef] [PubMed]
[32] Hurvitz, S.A., Hegg, R., Chung, W., Im, S., Jacot, W., Ganju, V., et al. (2023) Trastuzumab Deruxtecan versus Trastuzumab Emtansine in Patients with HER2-Positive Metastatic Breast Cancer: Updated Results from Destiny-Breast03, a Randomised, Open-Label, Phase 3 Trial. The Lancet, 401, 105-117. [Google Scholar] [CrossRef] [PubMed]
[33] Gennari, A., André, F., Barrios, C.H., Cortés, J., de Azambuja, E., DeMichele, A., et al. (2021) ESMO Clinical Practice Guideline for the Diagnosis, Staging and Treatment of Patients with Metastatic Breast Cancer. Annals of Oncology, 32, 1475-1495. [Google Scholar] [CrossRef] [PubMed]
[34] Xu, B., Yan, M., Ma, F., Hu, X., Feng, J., Ouyang, Q., et al. (2021) Pyrotinib Plus Capecitabine versus Lapatinib Plus Capecitabine for the Treatment of HER2-Positive Metastatic Breast Cancer (PHOEBE): A Multicentre, Open-Label, Randomised, Controlled, Phase 3 Trial. The Lancet Oncology, 22, 351-360. [Google Scholar] [CrossRef] [PubMed]
[35] Krop, I.E., Kim, S., Martin, A.G., LoRusso, P.M., Ferrero, J., Badovinac-Crnjevic, T., et al. (2017) Trastuzumab Emtansine versus Treatment of Physician’s Choice in Patients with Previously Treated HER2-Positive Metastatic Breast Cancer (TH3RESA): Final Overall Survival Results from a Randomised Open-Label Phase 3 Trial. The Lancet Oncology, 18, 743-754. [Google Scholar] [CrossRef] [PubMed]
[36] Saura, C., Oliveira, M., Feng, Y., Dai, M., Chen, S., Hurvitz, S.A., et al. (2020) Neratinib Plus Capecitabine versus Lapatinib Plus Capecitabine in HER2-Positive Metastatic Breast Cancer Previously Treated with ≥2 HER2-Directed Regimens: Phase III NALA Trial. Journal of Clinical Oncology, 38, 3138-3149. [Google Scholar] [CrossRef] [PubMed]
[37] Murthy, R.K., Loi, S., Okines, A., Paplomata, E., Hamilton, E., Hurvitz, S.A., et al. (2019) Tucatinib, Trastuzumab, and Capecitabine for HER2-Positive Metastatic Breast Cancer. New England Journal of Medicine, 382, 597-609. [Google Scholar] [CrossRef] [PubMed]
[38] Curigliano, G., Mueller, V., Borges, V., Hamilton, E., Hurvitz, S., Loi, S., et al. (2022) Tucatinib versus Placebo Added to Trastuzumab and Capecitabine for Patients with Pretreated HER2+ Metastatic Breast Cancer with and without Brain Metastases (HER2CLIMB): Final Overall Survival Analysis. Annals of Oncology, 33, 321-329. [Google Scholar] [CrossRef] [PubMed]
[39] Rugo, H.S., Im, S., Cardoso, F., Cortés, J., Curigliano, G., Musolino, A., et al. (2021) Efficacy of Margetuximab vs Trastuzumab in Patients with Pretreated ERBB2-Positive Advanced Breast Cancer. JAMA Oncology, 7, 573-584. [Google Scholar] [CrossRef] [PubMed]
[40] Romond, E.H., Perez, E.A., Bryant, J., Suman, V.J., Geyer, C.E., Davidson, N.E., et al. (2005) Trastuzumab Plus Adjuvant Chemotherapy for Operable HER2-Positive Breast Cancer. New England Journal of Medicine, 353, 1673-1684. [Google Scholar] [CrossRef] [PubMed]
[41] Cameron, D., Piccart-Gebhart, M.J., Gelber, R.D., Procter, M., Goldhirsch, A., de Azambuja, E., et al. (2017) 11 Years’ Follow-Up of Trastuzumab after Adjuvant Chemotherapy in HER2-Positive Early Breast Cancer: Final Analysis of the Herceptin Adjuvant (HERA) Trial. The Lancet, 389, 1195-1205. [Google Scholar] [CrossRef] [PubMed]
[42] Loibl, S., Jassem, J., Sonnenblick, A., Parlier, D., Winer, E., Bergh, J., et al. (2022) VP6-2022: Adjuvant Pertuzumab and Trastuzumab in Patients with Early HER-2 Positive Breast Cancer in APHINITY: 8.4 Years’ Follow-Up. Annals of Oncology, 33, 986-987. [Google Scholar] [CrossRef
[43] Piccart-Gebhart, M., Holmes, E., Baselga, J., de Azambuja, E., Dueck, A.C., Viale, G., et al. (2016) Adjuvant Lapatinib and Trastuzumab for Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Results from the Randomized Phase III Adjuvant Lapatinib and/or Trastuzumab Treatment Optimization Trial. Journal of Clinical Oncology, 34, 1034-1042. [Google Scholar] [CrossRef] [PubMed]
[44] Martin, M., Holmes, F.A., Ejlertsen, B., Delaloge, S., Moy, B., Iwata, H., et al. (2017) Neratinib after Trastuzumab-Based Adjuvant Therapy in HER2-Positive Breast Cancer (Extenet): 5-Year Analysis of a Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial. The Lancet Oncology, 18, 1688-1700. [Google Scholar] [CrossRef] [PubMed]
[45] von Minckwitz, G., Huang, C., Mano, M.S., Loibl, S., Mamounas, E.P., Untch, M., et al. (2019) Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer. New England Journal of Medicine, 380, 617-628. [Google Scholar] [CrossRef] [PubMed]
[46] Cortazar, P., Zhang, L., Untch, M., Mehta, K., Costantino, J.P., Wolmark, N., et al. (2014) Pathological Complete Response and Long-Term Clinical Benefit in Breast Cancer: The Ctneobc Pooled Analysis. The Lancet, 384, 164-172. [Google Scholar] [CrossRef] [PubMed]
[47] Guarneri, V., Griguolo, G., Miglietta, F., Conte, P.F., Dieci, M.V. and Girardi, F. (2021) Survival after Neoadjuvant Therapy with Trastuzumab-Lapatinib and Chemotherapy in Patients with HER2-Positive Early Breast Cancer: A Meta-Analysis of Randomised Trials. Annals of Oncology, 32, S407. [Google Scholar] [CrossRef
[48] Robidoux, A., Tang, G., Rastogi, P., Geyer, C.E., Azar, C.A., Atkins, J.N., et al. (2013) Lapatinib as a Component of Neoadjuvant Therapy for HER2-Positive Operable Breast Cancer (NSABP Protocol B-41): An Open-Label, Randomised Phase 3 Trial. The Lancet Oncology, 14, 1183-1192. [Google Scholar] [CrossRef] [PubMed]
[49] de Azambuja, E., Holmes, A.P., Piccart-Gebhart, M., Holmes, E., Di Cosimo, S., Swaby, R.F., et al. (2014) Lapatinib with Trastuzumab for HER2-Positive Early Breast Cancer (NeoALTTO): Survival Outcomes of a Randomised, Open-Label, Multicentre, Phase 3 Trial and Their Association with Pathological Complete Response. The Lancet Oncology, 15, 1137-1146. [Google Scholar] [CrossRef] [PubMed]
[50] Huober, J., Holmes, E., Baselga, J., de Azambuja, E., Untch, M., Fumagalli, D., et al. (2019) Survival Outcomes of the NeoALTTO Study (BIG 1-06): Updated Results of a Randomised Multicenter Phase III Neoadjuvant Clinical Trial in Patients with HER2-Positive Primary Breast Cancer. European Journal of Cancer, 118, 169-177. [Google Scholar] [CrossRef] [PubMed]
[51] Nuciforo, P., Townend, J., Piccart, M.J., Fielding, S., Gkolfi, P., El-Abed, S., et al. (2023) Ten-Year Survival of Neoadjuvant Dual HER2 Blockade in Patients with HER2-Positive Breast Cancer. European Journal of Cancer, 181, 92-101. [Google Scholar] [CrossRef] [PubMed]
[52] Harbeck, N., Gluz, O., Christgen, M., Kates, R.E., Braun, M., Küemmel, S., et al. (2017) De-Escalation Strategies in Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Early Breast Cancer (BC): Final Analysis of the West German Study Group Adjuvant Dynamic Marker-Adjusted Personalized Therapy Trial Optimizing Risk Assessment and Therapy Response Prediction in Early BC HER2-and Hormone Receptor–positive Phase II Randomized Trial—Efficacy, Safety, and Predictive Markers for 12 Weeks of Neoadjuvant Trastuzumab Emtansine with or without Endocrine Therapy (ET) versus Trastuzumab Plus ET. Journal of Clinical Oncology, 35, 3046-3054. [Google Scholar] [CrossRef] [PubMed]
[53] Prat, A. and Baselga, J. (2008) The Role of Hormonal Therapy in the Management of Hormonal-Receptor-Positive Breast Cancer with Co-Expression of HER2. Nature Clinical Practice Oncology, 5, 531-542. [Google Scholar] [CrossRef] [PubMed]
[54] Gray, R., Bradley, R., Braybrooke, J., Liu, Z., Peto, R., Davies, L., et al. (2019) Increasing the Dose Intensity of Chemotherapy by More Frequent Administration or Sequential Scheduling: A Patient-Level Meta-Analysis of 37 298 Women with Early Breast Cancer in 26 Randomised Trials. The Lancet, 393, 1440-1452. [Google Scholar] [CrossRef] [PubMed]
[55] Bradley, R., Braybrooke, J., Gray, R., et al. (2022) Aromatase Inhibitors versus Tamoxifen in Premenopausal Women with Oestrogen Receptor-Positive Early-Stage Breast Cancer Treated with Ovarian Suppression: A Patient-Level Meta-Analysis of 7030 Women from Four Randomised Trials. The Lancet Oncology, 23, 382-392.
[56] Gomez Marti, J.L., Nasrazadani, A. and Brufsky, A.M. (2021) Ovarian Function Suppression as a Potential Mechanism of Chemotherapy. EBioMedicine, 70, Article 103489. [Google Scholar] [CrossRef] [PubMed]
[57] Lambertini, M., Campbell, C., Bines, J., Korde, L.A., Izquierdo, M., Fumagalli, D., et al. (2019) Adjuvant Anti-HER2 Therapy, Treatment-Related Amenorrhea, and Survival in Premenopausal HER2-Positive Early Breast Cancer Patients. Journal of the National Cancer Institute, 111, 86-94. [Google Scholar] [CrossRef] [PubMed]
[58] Peleg Hasson, S., Brezis, M.R., Shachar, E., Shachar, S.S., Wolf, I. and Sonnenblick, A. (2021) Adjuvant Endocrine Therapy in HER2-Positive Breast Cancer Patients: Systematic Review and Meta-Analysis. ESMO Open, 6, Article 100088. [Google Scholar] [CrossRef] [PubMed]
[59] De Laurentiis, M., Arpino, G., Massarelli, E., Ruggiero, A., Carlomagno, C., Ciardiello, F., et al. (2005) A Meta-Analysis on the Interaction between HER-2 Expression and Response to Endocrine Treatment in Advanced Breast Cancer. Clinical Cancer Research, 11, 4741-4748. [Google Scholar] [CrossRef] [PubMed]
[60] Kawalec, P., Łopuch, S. and Mikrut, A. (2015) Effectiveness of Targeted Therapy in Patients with Previously Untreated Metastatic Breast Cancer: A Systematic Review and Meta-Analysis. Clinical Breast Cancer, 15, 90-100.e1. [Google Scholar] [CrossRef] [PubMed]