Ecological environment of tumor modulates drug resistance of breast tumor

doi:10.3877/cma.j.issn.1674-0807.2022.02.001

Abstract

Abstract:

Systemic therapy including chemotherapy, endocrine therapy and targeted therapy, is currently performed to reduce the risk of recurrence and prolong the survival of breast cancer patients. However, almost 40% breast cancer patients suffer recurrence due to drug resistance, suggesting that traditional treatment regimens fail to completely kill tumor cells. The theory of tumor ecology provides a new insight to understand treatment resistance of tumors and find new targets of drugs. According to tumor ecology, the interaction between tumors and surrounding microenvironment can affect the initiation, development and treatment sensitivity of tumors. In this review, the author illustrates the relationship between drug resistance of breast cancer and tumor ecological environment composed of breast cancer cells and microenvironment, and reviews the related clinical research progress, in order to provide references for reversing drug resistance of breast cancer.

Key words: Breast neoplasms, Ecology, Drug tolerance

Erwei Song. Ecological environment of tumor modulates drug resistance of breast tumor[J]. Chinese Journal of Breast Disease(Electronic Edition), 2022, 16(02): 67-73.

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References 58

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乳腺癌	临床试验	分期	研究目的	状态	重要结果	参考文献
三阴型	KEYNOTE-119(NCT02555657)	3期	PD-L1抑制剂帕博利珠单克隆抗体比卡培他滨、艾立布林、吉西他滨或长春瑞滨	完成	mOS：12.7个月比11.6个月，HR＝ 0.78	[26]
	IMpassion 030(NCT03498716)	3期	PD-L1抑制剂tezolizumab+蒽环类+紫杉醇比蒽环类+紫杉醇	进行中	NA	[27]
	A-BRAVE(NCT02926196)	3期	PD-L1抑制剂avelumab比观察	进行中	NA	[28]
	SWOG 1418(NCT02954874)	3期	PD-L1抑制剂帕博利珠单克隆抗体比观察	进行中	NA	[29]
	SAFIR02- BREAST IMMUNO (NCT02299999)	2期	PD-L1抑制剂durvalumab比化疗	完成	mOS: 21.7个月比17.9个月，HR ＝ 0.84	[30]
	DORA(NCT03167619)	2期	奥拉帕尼+ PD-L1抑制剂durvalumab比奥拉帕尼	进行中	NA	[31]
	KEYLYNK-009(NCT04191135)	2期/3期	PD-L1抑制剂帕博利珠单克隆抗体+奥拉帕尼比PD-L1抑制剂帕博利珠单克隆抗体+化疗	进行中	NA	[32]
	KEYNOTE-173(NCT02622074)	1b期	PD-L1抑制剂帕博利珠单克隆抗体+白蛋白紫杉醇+多柔比星+环磷酰胺比PD-L1抑制剂帕博利珠单克隆抗体+白蛋白紫杉醇+多柔比星+环磷酰胺+卡铂	完成	pCR率：60%；1年OS率：80%~100%	[33]
激素受体阳性型	I-SPY2 NCT01042379	2期	PD-L1抑制剂帕博利珠单克隆抗体+紫杉醇+多柔比星+环磷酰胺比标准治疗(紫杉醇+多柔比星+环磷酰胺)	完成	pCR率：30%比13%	[34]
	EYNOTE-28 NCT02054806	1b期	PD-L1抑制剂帕博利珠单克隆抗体	完成	mOS：8.6个月	[35]
	NCT03051659	2期	PD-L1抑制剂帕博利珠单克隆抗体+艾立布林比艾立布林	完成	mPFS：4.1个月比4.2个月	[36]
	NCT02971748	2期	PD-L1抑制剂帕博利珠单克隆抗体+内分泌治疗	进行中	NA	[37]
	NCT03879174	2期	PD-L1抑制剂帕博利珠单克隆抗体+他莫昔芬	进行中	NA	[38]
HER-2阳性型	KATE2(NCT02924883)	2期	T-DM1+PD-L1抑制剂阿特珠单克隆抗体比T-DM1	完成	pCR率：57.6%比41.4%	[39]

乳腺癌	临床试验	分期	研究目的	状态	重要结果	参考文献
三阴型	KEYNOTE-119(NCT02555657)	3期	PD-L1抑制剂帕博利珠单克隆抗体比卡培他滨、艾立布林、吉西他滨或长春瑞滨	完成	mOS：12.7个月比11.6个月，HR＝ 0.78	[26]
	IMpassion 030(NCT03498716)	3期	PD-L1抑制剂tezolizumab+蒽环类+紫杉醇比蒽环类+紫杉醇	进行中	NA	[27]
	A-BRAVE(NCT02926196)	3期	PD-L1抑制剂avelumab比观察	进行中	NA	[28]
	SWOG 1418(NCT02954874)	3期	PD-L1抑制剂帕博利珠单克隆抗体比观察	进行中	NA	[29]
	SAFIR02- BREAST IMMUNO (NCT02299999)	2期	PD-L1抑制剂durvalumab比化疗	完成	mOS: 21.7个月比17.9个月，HR ＝ 0.84	[30]
	DORA(NCT03167619)	2期	奥拉帕尼+ PD-L1抑制剂durvalumab比奥拉帕尼	进行中	NA	[31]
	KEYLYNK-009(NCT04191135)	2期/3期	PD-L1抑制剂帕博利珠单克隆抗体+奥拉帕尼比PD-L1抑制剂帕博利珠单克隆抗体+化疗	进行中	NA	[32]
	KEYNOTE-173(NCT02622074)	1b期	PD-L1抑制剂帕博利珠单克隆抗体+白蛋白紫杉醇+多柔比星+环磷酰胺比PD-L1抑制剂帕博利珠单克隆抗体+白蛋白紫杉醇+多柔比星+环磷酰胺+卡铂	完成	pCR率：60%；1年OS率：80%~100%	[33]
激素受体阳性型	I-SPY2 NCT01042379	2期	PD-L1抑制剂帕博利珠单克隆抗体+紫杉醇+多柔比星+环磷酰胺比标准治疗(紫杉醇+多柔比星+环磷酰胺)	完成	pCR率：30%比13%	[34]
	EYNOTE-28 NCT02054806	1b期	PD-L1抑制剂帕博利珠单克隆抗体	完成	mOS：8.6个月	[35]
	NCT03051659	2期	PD-L1抑制剂帕博利珠单克隆抗体+艾立布林比艾立布林	完成	mPFS：4.1个月比4.2个月	[36]
	NCT02971748	2期	PD-L1抑制剂帕博利珠单克隆抗体+内分泌治疗	进行中	NA	[37]
	NCT03879174	2期	PD-L1抑制剂帕博利珠单克隆抗体+他莫昔芬	进行中	NA	[38]
HER-2阳性型	KATE2(NCT02924883)	2期	T-DM1+PD-L1抑制剂阿特珠单克隆抗体比T-DM1	完成	pCR率：57.6%比41.4%	[39]

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