摘要
三阴性乳腺癌(TNBC)是乳腺癌中最具侵袭性的亚型之一,占病例的15-20%,其定义为缺乏激素受体,即雌激素受体(ER),孕激素受体(PR)和人表皮生长受体2(HER2)的表达。 由于缺乏分子靶向治疗的标志物(ER,PR和HER-2 / Neu),TNBC的治疗比其他亚型乳腺癌更具挑战性,常规化疗药物仍然是其治疗方案的主要手段 。 尽管TNBC比其他亚型更具化学反应性,但不幸的是,最初对化学疗法的良好反应最终变成了难治性耐药。 由于肿瘤细胞固有的遗传不稳定性来发展内在的和获得性的耐药性,因此使用单一疗法来治疗癌症,尤其是像TNBC这样的高级别肿瘤,几乎毫无价值。 因此,两种或多种具有不同作用机理的药物的混合物更为有效,可以成功地控制该疾病。 此外,联合治疗在每种单一药物的剂量较低时显示出更多或至少相同的效果,并降低了化学抗药性的可能性。 在本文中,我们阐明了针对PARP,EGFR,PI3K途径,AR和wnt信号传导,HDAC,MEK途径的新型组合方法,可有效治疗TNBC等高级别肿瘤并降低耐药性发作。
关键词: 乳腺癌,TNBC,耐药性,联合疗法,PARPi,Wnt /β-catenin,Hsp90。
图形摘要
[http://dx.doi.org/10.2147/OTT.S190432] [PMID: 30774359]
[http://dx.doi.org/10.3322/caac.21208] [PMID: 24399786]
[http://dx.doi.org/10.3322/caac.21203] [PMID: 24114568]
[http://dx.doi.org/10.1038/35021093] [PMID: 10963602]
[http://dx.doi.org/10.1073/pnas.191367098] [PMID: 11553815]
[http://dx.doi.org/10.1200/JCO.2007.14.4287] [PMID: 18413639]
[http://dx.doi.org/10.3390/cancers10120514]
[http://dx.doi.org/10.1158/1078-0432.CCR-06-3045] [PMID: 17671126]
[http://dx.doi.org/10.1200/JCO.2009.25.9820] [PMID: 20498394]
[http://dx.doi.org/10.1634/theoncologist.2012-0397] [PMID: 23404817]
[http://dx.doi.org/10.1186/bcr2635] [PMID: 20813035]
[http://dx.doi.org/10.1158/1078-0432.CCR-06-1109] [PMID: 17438091]
[http://dx.doi.org/10.1016/S1470-2045(14)70160-3] [PMID: 24794243]
[http://dx.doi.org/10.1200/JCO.2014.57.6660] [PMID: 25847936]
[http://dx.doi.org/10.1200/JCO.2015.61.1459] [PMID: 26195705]
[http://dx.doi.org/10.1158/1078-0432.CCR-14-0432] [PMID: 25208879]
[http://dx.doi.org/10.1172/JCI45014] [PMID: 21633166]
[http://dx.doi.org/10.4161/cbt.21187] [PMID: 22825326]
[http://dx.doi.org/10.1155/2014/532161] [PMID: 25140317]
[http://dx.doi.org/10.1158/1078-0432.CCR-07-1658] [PMID: 18316557]
[http://dx.doi.org/10.1093/annonc/mdt248] [PMID: 23925999]
[PMID: 25120810]
[http://dx.doi.org/10.1002/gcc.21922] [PMID: 22170730]
[http://dx.doi.org/10.3892/ijo.2015.2982] [PMID: 25955731]
[http://dx.doi.org/10.1371/journal.pone.0088557] [PMID: 24551119]
[http://dx.doi.org/10.1038/nature10933] [PMID: 22495314]
[http://dx.doi.org/10.1371/journal.pone.0048402] [PMID: 23119004]
[http://dx.doi.org/10.1309/AJCPR11DEAYPTUSL] [PMID: 24515759]
[http://dx.doi.org/10.1111/j.1365-2559.2011.03884.x] [PMID: 22014057]
[http://dx.doi.org/10.1093/annonc/mdt011] [PMID: 23406733]
[http://dx.doi.org/10.1007/s00280-014-2404-1] [PMID: 24526178]
[http://dx.doi.org/10.1200/JCO.2005.07.501] [PMID: 16192605]
[http://dx.doi.org/10.1038/ng.3641] [PMID: 27526321]
[PMID: 27284266]
[http://dx.doi.org/10.1634/theoncologist.2016-0067] [PMID: 27401886]
[http://dx.doi.org/10.1016/j.tips.2015.08.009] [PMID: 26538316]
[http://dx.doi.org/10.1016/j.ctrv.2016.12.010] [PMID: 28104566]
[http://dx.doi.org/10.1016/j.ygyno.2015.02.017] [PMID: 25725131]
[http://dx.doi.org/10.1056/NEJMoa1706450] [PMID: 28578601]
[http://dx.doi.org/10.1038/nature03445] [PMID: 15829967]
[http://dx.doi.org/10.1200/JCO.2014.55.2984] [PMID: 25349301]
[http://dx.doi.org/10.1093/annonc/mdu187] [PMID: 24827126]
[http://dx.doi.org/10.1016/j.ctrv.2017.11.003] [PMID: 29202431]
[http://dx.doi.org/10.1158/1078-0432.CCR-15-2137] [PMID: 26801247]
[http://dx.doi.org/10.1200/jco.2014.32.15_suppl.2569]
[http://dx.doi.org/10.3892/ijo.2013.2240] [PMID: 24378347]
[http://dx.doi.org/10.1158/1078-0432.CCR-16-3215] [PMID: 28167507]
[http://dx.doi.org/10.1158/2326-6066.CIR-15-0044] [PMID: 26138335]
[http://dx.doi.org/10.1016/j.ctrv.2018.05.014] [PMID: 29870916]
[http://dx.doi.org/10.1093/emboj/16.7.1647] [PMID: 9130710]
[http://dx.doi.org/10.4103/0974-2727.163129] [PMID: 26417156]
[http://dx.doi.org/10.18632/oncotarget.2209] [PMID: 25051360]
[http://dx.doi.org/10.1387/ijdb.113396se] [PMID: 22161825]
[http://dx.doi.org/10.7150/jca.2.324] [PMID: 21716849]
[http://dx.doi.org/10.1016/j.ccr.2005.05.007] [PMID: 15950906]
[http://dx.doi.org/10.1016/j.radonc.2013.06.010] [PMID: 23830194]
[http://dx.doi.org/10.1074/jbc.M111.240796] [PMID: 21487020]
[http://dx.doi.org/10.1007/s00280-013-2112-2] [PMID: 23430121]
[http://dx.doi.org/10.1200/JCO.2008.18.1925] [PMID: 19620495]
[http://dx.doi.org/10.1200/jco.2010.28.15_suppl.1065]
[http://dx.doi.org/10.1200/JCO.2012.46.2408] [PMID: 23733761]
[http://dx.doi.org/10.1200/JCO.2010.34.5579] [PMID: 22665533]
[http://dx.doi.org/10.1093/annonc/mdu183] [PMID: 24827135]
[http://dx.doi.org/10.1073/pnas.0409610102] [PMID: 15684082]
[http://dx.doi.org/10.1073/pnas.1220763110] [PMID: 23319610]
[http://dx.doi.org/10.1038/srep39355] [PMID: 27976709]
[http://dx.doi.org/10.3892/or.2014.3665] [PMID: 25501339]
[http://dx.doi.org/10.1111/jcmm.12046] [PMID: 23601074]
[http://dx.doi.org/10.1111/nyas.12499] [PMID: 25123209]
[http://dx.doi.org/10.1021/bc800289a] [PMID: 18803412]
[http://dx.doi.org/10.1158/1535-7163.MCT-15-0901] [PMID: 26846818]
[http://dx.doi.org/10.1200/JCO.2016.70.8297] [PMID: 28291390]
[http://dx.doi.org/10.1007/s10549-007-9584-x] [PMID: 17458693]
[http://dx.doi.org/10.1158/1078-0432.CCR-16-2401] [PMID: 28069724]
[http://dx.doi.org/10.1158/1078-0432.CCR-08-1763] [PMID: 19276248]
[http://dx.doi.org/10.1200/JCO.2014.59.0018] [PMID: 27621407]
[http://dx.doi.org/10.2174/1574892811666160519113731]
[http://dx.doi.org/10.1371/journal.pone.0141763] [PMID: 26540293]
[http://dx.doi.org/10.1126/science.296.5573.1655] [PMID: 12040186]
[http://dx.doi.org/10.1158/1078-0432.CCR-04-0361] [PMID: 15501983]
[http://dx.doi.org/10.1007/s10549-010-1055-0] [PMID: 20686837]
[http://dx.doi.org/10.1093/annonc/mdu124] [PMID: 24669015]
[http://dx.doi.org/10.18632/oncotarget.10195] [PMID: 27374081]
[http://dx.doi.org/10.3892/or.2016.4799] [PMID: 27175939]
[http://dx.doi.org/10.1158/1535-7163.MCT-10-0925] [PMID: 21690228]
[http://dx.doi.org/10.1016/j.molonc.2013.02.003] [PMID: 23478237]
[http://dx.doi.org/10.1038/nrclinonc.2013.10] [PMID: 23400000]
[http://dx.doi.org/10.1158/2159-8290.CD-11-0348] [PMID: 22915752]
[http://dx.doi.org/10.1200/jco.2014.32.15_suppl.2510]
[http://dx.doi.org/10.1158/1538-7445.sabcs15-ot1-03-13]
[http://dx.doi.org/10.1158/0008-5472.CAN-05-2925] [PMID: 16452206]
[http://dx.doi.org/10.1158/1078-0432.CCR-10-1694] [PMID: 21325073]
[http://dx.doi.org/10.1158/1535-7163.MCT-14-0926] [PMID: 25713333]
[http://dx.doi.org/10.2147/OTT.S126051] [PMID: 29033586]
[http://dx.doi.org/10.1245/s10434-013-3260-7] [PMID: 24046116]
[http://dx.doi.org/10.1007/s12672-015-0232-3] [PMID: 26201402]
[http://dx.doi.org/10.1158/1078-0432.CCR-13-0799] [PMID: 23948975]
[http://dx.doi.org/10.1159/000443052] [PMID: 26938985]
[http://dx.doi.org/10.1200/JCO.2016.71.3495] [PMID: 29373071]
[http://dx.doi.org/10.1186/s13058-014-0406-x] [PMID: 25103565]
[http://dx.doi.org/10.1002/path.4280] [PMID: 24114677]
[http://dx.doi.org/10.18632/oncotarget.197] [PMID: 21317458]
[http://dx.doi.org/10.1158/1078-0432.CCR-15-0857] [PMID: 26542058]
[http://dx.doi.org/10.1038/bjc.2015.464] [PMID: 26742006]
[http://dx.doi.org/10.1038/npjbcancer.2016.2] [PMID: 28721372]
[http://dx.doi.org/10.1093/annonc/mdw067] [PMID: 27052658]
[http://dx.doi.org/10.1007/s12015-014-9515-2] [PMID: 24825509]
[http://dx.doi.org/10.1016/j.cell.2006.10.018] [PMID: 17081971]
[http://dx.doi.org/10.3390/cancers8070060]
[http://dx.doi.org/10.3390/cells8080826] [PMID: 31382613]
[http://dx.doi.org/10.1038/modpathol.2010.205] [PMID: 21076461]
[http://dx.doi.org/10.1371/journal.pone.0117097] [PMID: 25658419]
[http://dx.doi.org/10.3390/ijms19051524] [PMID: 29783777]
[http://dx.doi.org/10.1158/0008-5472.CAN-14-2041] [PMID: 25660951]
[http://dx.doi.org/10.1016/j.canlet.2019.02.018] [PMID: 30771433]
[PMID: 29491053]
[http://dx.doi.org/10.1016/j.biocel.2018.08.004] [PMID: 30096373]
[http://dx.doi.org/10.1042/bj20021321]
[http://dx.doi.org/10.1016/j.molonc.2007.01.001] [PMID: 19383284]
[http://dx.doi.org/10.1158/1078-0432.CCR-04-2088] [PMID: 16000590]
[http://dx.doi.org/10.1371/journal.pone.0014335] [PMID: 21179472]
[http://dx.doi.org/10.18632/oncotarget.2154] [PMID: 25026298]
[http://dx.doi.org/10.1186/s13058-015-0534-y] [PMID: 25888415]
[http://dx.doi.org/10.1038/ncomms4361] [PMID: 24553445]
[http://dx.doi.org/10.1128/MMBR.00031-10] [PMID: 21372320]
[http://dx.doi.org/10.1038/nrc969] [PMID: 12509763]
[http://dx.doi.org/10.1158/1535-7163.MCT-12-0781] [PMID: 23171949]
[http://dx.doi.org/10.1158/1538-7445.sabcs17-p5-21-01]
[http://dx.doi.org/10.1016/j.ejca.2013.03.020] [PMID: 23583440]
[http://dx.doi.org/10.1002/jcb.25220] [PMID: 25959272]
[http://dx.doi.org/10.1016/j.biopha.2015.08.031] [PMID: 26463630]
[http://dx.doi.org/10.1158/1535-7163.MCT-15-0096] [PMID: 26443806]
[http://dx.doi.org/10.1158/1535-7163.MCT-08-0017] [PMID: 18606717]
[http://dx.doi.org/10.1002/ijc.28566] [PMID: 24615768]
[http://dx.doi.org/10.1186/1750-2187-5-8] [PMID: 20624308]
[PMID: 30949414]
[http://dx.doi.org/10.1038/nm.4032] [PMID: 26779812]
[http://dx.doi.org/10.1038/nrc2887] [PMID: 20651736]
[http://dx.doi.org/10.1158/1078-0432.CCR-11-1000] [PMID: 22215907]
[http://dx.doi.org/10.1016/j.cell.2011.02.013] [PMID: 21376230]
[http://dx.doi.org/10.1016/bs.acr.2015.12.001] [PMID: 26916001]
[http://dx.doi.org/10.1186/bcr2557] [PMID: 20226014]
[http://dx.doi.org/10.1158/0008-5472.CAN-06-4511] [PMID: 17409397]
[http://dx.doi.org/10.1186/bcr3168] [PMID: 22510516]
[PMID: 12006510]
[http://dx.doi.org/10.1158/1078-0432.CCR-05-0518] [PMID: 16203796]
[http://dx.doi.org/10.1007/s00280-004-0865-3] [PMID: 15338192]
[http://dx.doi.org/10.1007/s10637-013-9971-6] [PMID: 23686707]
[http://dx.doi.org/10.1158/1078-0432.CCR-13-2166] [PMID: 24173541]
[http://dx.doi.org/10.1016/j.clbc.2013.12.012] [PMID: 24512858]
[http://dx.doi.org/10.18632/oncotarget.8974] [PMID: 27129177]
[http://dx.doi.org/10.1158/1078-0432.CCR-11-0072] [PMID: 21558407]
[http://dx.doi.org/10.1186/s12885-019-5295-z]
[http://dx.doi.org/10.1593/neo.10328] [PMID: 20689754]
[http://dx.doi.org/10.1371/journal.pone.0033017] [PMID: 22457730]
[http://dx.doi.org/10.1093/annonc/mdr261] [PMID: 21700731]
[http://dx.doi.org/10.1016/j.clbc.2011.03.021] [PMID: 21729667]
[http://dx.doi.org/10.1158/1078-0432.CCR-11-0288] [PMID: 22028489]
[http://dx.doi.org/10.1016/j.jss.2013.06.041] [PMID: 23899511]