PARP 抑制剂耐药的 BRCA 基因突变晚期乳腺癌:现状与新兴疗法。

IF 2.8 4区 医学 Q2 ONCOLOGY
Carmine Valenza, Renato Maria Marsicano, Dario Trapani, Giuseppe Curigliano
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引用次数: 0

摘要

综述目的:接受PARP抑制剂(PARPi)治疗的晚期乳腺癌(aBC)患者最终会因出现耐药性而导致疾病进展。本综述旨在描述 PARPi 耐药 BRCA 基因突变 aBC 患者的治疗、分子状况和创新疗法:在PARPi失效后的情况下,目前尚无特异性疗法,抗体药物共轭物或非铂类化疗(PBC)是这种情况下的最佳治疗选择。靶上 PARPi 抗性的机制可分为逆转(60%)和非逆转(40%);逆转突变可恢复 PARP 功能。根据临床有效性的初步证据,这些改变与 PARPi 和 PBC 的较低疗效相关。小结:由于缺乏特异性靶向疗法以及有效的预后和预测生物标志物,PARPi 耐药 aBC 的临床需求尚未得到满足。我们需要不断努力,更好地确定 PARPi 耐药的机制,进而开发基于生物标志物的治疗方法,以预防或克服耐药。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PARP inhibitor resistant BRCA-mutated advanced breast cancer: current landscape and emerging treatments.

Purpose of review: Patients with advanced breast cancer (aBC) treated with PARP inhibitors (PARPi) can eventually experience disease progression for emerging treatment resistance. This review aims to depict the treatment the molecular landscape, and the innovative therapies for patients with PARPi-resistant BRCA-mutated aBC.

Recent findings: No specific therapy is specifically available in the setting post-PARPi-failure, with antibody-drug conjugates or nonplatinum-based chemotherapy (PBC) representing the best treatment options in this setting. Mechanisms of on-target PARPi resistance can be classified in reversions (60%) and nonreversion (40%); reverse mutations restore PARP functions. According to the first evidence of clinical validity, these alterations are associated with lower efficacy of PARPi and PBC. However, their clinical utility needs to be assessed.

Summary: PARPi-resistant aBC represents a clinical unmet need due to the lack of specific targeted therapies and validated prognostic and predictive biomarkers. Constant efforts are required to better define the mechanisms of PARPi resistance and, consequently, develop biomarker-based treatment approach to prevent or overcame resistance.

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来源期刊
Current Opinion in Oncology
Current Opinion in Oncology 医学-肿瘤学
CiteScore
6.10
自引率
2.90%
发文量
130
审稿时长
4-8 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.
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