拉帕替尼在乳腺癌中的应用及其耐药机制研究现状

随着分子肿瘤学的发展,乳腺癌进入了分子分型时代。基于患者不同生物标志物表达的个体化医疗已经成为目前乳腺癌治疗的模式。HER2阳性乳腺癌侵袭性高、预后差,占所有乳腺癌患者的20%~30%。曲妥珠单抗作为第一个人源化单克隆抗体,以HER2为靶点,改善了这部分患者的预后,因此乳腺癌相关各大临床实践指南和专家共识明确推荐HER2阳性乳腺癌患者不同阶段均可以使用曲妥珠单抗进行抗HER2治疗。但是曲妥珠单抗的心脏毒性及原发、继发耐药等问题迫使临床医生对二线抗HER2治疗进行探索。拉帕替尼作为第一个被批准用于临床作用于HER1和HER2双靶点的酪氨酸激酶抑制剂,是曲妥珠单抗失败后的不错选择。本文对拉帕替尼在乳腺癌中的应用、相关临床研究及其耐药机制研究进行简要综述。

The application of Lapatinib in breast cancer and its mechanism of drug resistance

With development of molecular biology,breast cancer has entered an era of molecular classification,thus making biomarker based personalized medicine is the trend of breast cancer treatment.HER2-positive breast cancer of high invasiveness and bad prognosis accounts for 20%~30%.Targeting HER2,trastuzumab is the first humanized monoclonal antibody which can improve the prognosis of HER2-positive patients and it is recommended by guidelines and expert consensus at home and abroad for anti-HER2 therapy in any stage.However,the cardiotoxicity,de novo resistance and acquired resistance of trastuzumab make the clinician to explore the second line anti-HER2 therapy.Lapatinib is the first FDA approved and HER1,HER2 double-targeting tyrosine kinase inhibitor which can be a better choice after failure with trastuzumab.This article reviews the application,some clinical and mechanism of drug resistance researches of Lapatinib.