HER2阳性乳腺癌靶向治疗研究进展
Research Progress in Targeted Therapy for HER2-Positive Breast Cancer
DOI: 10.12677/acm.2026.1652040, PDF,   
作者: 程晗兵：西安医学院研究生工作部，陕西 西安；宋张骏*：陕西省人民医院乳腺诊疗中心，陕西 西安
关键词: HER2阳性乳腺癌；靶向治疗；精准医疗；HER-2 Positive Breast Cancer； Targeted Therapy； Precision Medicine
摘要: 乳腺癌是全球女性发病率最高的恶性肿瘤，其中人表皮生长因子受体2 (HER2)阳性亚型约占15%~20%，HER2阳性乳腺癌具有增殖侵袭能力强、预后较差的特点。自曲妥珠单抗问世以来，抗HER2靶向治疗极大改善了该类患者的生存结局。近年来治疗模式从单克隆抗体单靶、双靶治疗，逐步发展至抗体偶联药物(ADC)与小分子酪氨酸激酶抑制剂(TKI)联合应用，形成了覆盖新辅助、辅助及晚期解救的完整治疗体系。然而，原发性与继发性耐药仍是制约疗效的关键问题，其机制涉及HER2通路异常、旁路激活、肿瘤微环境重塑及表型转化等多个层面。近年来，针对耐药机制的精准联合治疗、新型靶向药物及免疫联合策略不断涌现。本文就HER2阳性乳腺癌靶向治疗的临床研究进展、治疗策略及耐药机制进行综述。
Abstract: Breast cancer is the most common malignant tumor among women worldwide, with the human epidermal growth factor receptor 2 (HER2)-positive subtype accounting for approximately 15% to 20% of cases. HER2-positive breast cancer is characterized by strong proliferative and invasive potential and a relatively poor prognosis. Since the advent of trastuzumab, anti-HER2 targeted therapy has significantly improved survival outcomes for these patients. In recent years, the treatment paradigm has evolved from single-agent or dual-agent monoclonal antibody-based targeted therapy to the combined use of antibody-drug conjugates (ADCs) and small-molecule tyrosine kinase inhibitors (TKIs), establishing a comprehensive treatment system that spans neoadjuvant, adjuvant, and advanced salvage settings. However, primary and acquired resistance remain critical challenges limiting therapeutic efficacy, with underlying mechanisms involving aberrations in the HER2 signaling pathway, activation of bypass pathways, remodeling of the tumor microenvironment, and phenotypic switching. In recent years, precision-based combination strategies targeting resistance mechanisms, novel targeted agents, and immunotherapy combinations have continued to emerge. This article reviews the clinical research progress, treatment strategies, and resistance mechanisms related to targeted therapy for HER2-positive breast cancer.
文章引用：程晗兵, 宋张骏. HER2阳性乳腺癌靶向治疗研究进展[J]. 临床医学进展, 2026, 16(5): 2297-2303. https://doi.org/10.12677/acm.2026.1652040

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