三阴性乳腺癌的治疗：现状与展望

三阴性乳腺癌仍然是侵袭性强且生物学异质性高的乳腺癌亚型，虽然治疗手段不断拓展，但是在许多情况下，实现持久的疾病控制仍然是临床挑战。现有的综述通常按药物类别或分子亚型对三阴性乳腺癌的治疗进行分类，这可能掩盖治疗效果如何受到生物学因素相互作用的影响。

2026年8月26日，美国华裔血液及肿瘤专家学会官方期刊、英国《生物医学中心》旗下《血液及肿瘤学杂志》在线发表复旦大学附属肿瘤医院王子逊①、刘西禹①、吴语潇①、肖玉铃①、葛丽萍①、吴松阳①✉️、江一舟✉️和邵志敏✉️等学者的长篇综述，通过三层框架回顾现有和新兴的治疗策略：肿瘤细胞内在靶点、局部免疫和基质微环境、宿主全身调节因子，总结现有治疗方法，包括化疗、免疫检查点阻断、抗体缀合药物和生物学标志物已明确的PARP抑制剂，并与正在成熟或探索的策略进行区分，例如通路靶向治疗、表观遗传调控、抗血管生成联合疗法、调控性细胞死亡诱导、细胞疗法、疫苗、微生物组相关干预、液体活检、人工智能支持的多组学和适应性试验设计，该框架将证据水平、疾病分期、生物学标志物可靠性和患者耐受性整合于三阴性乳腺癌精准疗法的治疗选择，全文长达30页，参考文献多达392篇。

三阴性乳腺癌的多层次生物学特征及分类演变

三阴性乳腺癌的抗体缀合药物临床试验

三阴性乳腺癌的PARP抑制剂关键研究

三阴性乳腺癌的代表性铁死亡诱导因子及其机制分类

三阴性乳腺癌的免疫检查点抑制剂关键试验

三阴性乳腺癌的抗血管治疗经典药物

三阴性乳腺癌的全身代谢干预试验

针对三阴性乳腺癌高度异质性的创新临床试验设计

三阴性乳腺癌的现有、新兴和未来治疗策略

J Hematol Oncol. 2026 Aug 26;19:57. IF: 47.8

Current and future therapies for triple-negative breast cancer.

Wang ZX, Liu XY, Wu YX, Xiao YL, Ge LP, Wu SY, Jiang YZ, Shao ZM.

Fudan University Shanghai Cancer Center, Shanghai, China; Shanghai Medical College, Fudan University Shanghai, Shanghai, China.

Triple-negative breast cancer remains an aggressive and biologically heterogeneous breast cancer subtype. Although the therapeutic landscape has expanded, durable disease control remains clinically challenging in many settings. Existing reviews often organize TNBC therapy by drug class or molecular subtype, which can obscure how treatment response is shaped by interacting biological layers. Here, we review current and emerging therapeutic strategies through a three-layer framework: tumor-cell-intrinsic vulnerabilities, the local immune and stromal microenvironment, and host-level systemic modifiers. We summarize established approaches, including chemotherapy, immune checkpoint blockade, antibody-drug conjugates and PARP inhibition in biomarker-defined settings, and distinguish them from maturing or exploratory strategies such as pathway-directed therapy, epigenetic modulation, anti-vascular combinations, regulated cell-death induction, cellular therapy, vaccines, microbiome-related interventions, liquid biopsy, AI-supported multiomics and adaptive trial designs. This framework integrates evidence level, disease stage, biomarker reliability and patient tolerance into treatment selection for TNBC precision therapy.

KEYWORDS: Integrative therapy; Multilevel tumor biology; Precision oncology; Triple-negative breast cancer; Tumor heterogeneity

PMID: 42649503

DOI: 10.1186/s13045-026-01839-x

来源：sibcs

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