I. Endocrine Therapy: An Effective Option for Hormone Receptor-Positive Breast Cancer
For patients with hormone receptor (HR)-positive, HER2-negative breast cancer, endocrine therapy remains one of the main treatment options. Endocrine therapy works by blocking or reducing estrogen levels in the body, thereby inhibiting cancer cell growth. Common endocrine agents include tamoxifen, aromatase inhibitors (such as letrozole and anastrozole), and selective estrogen receptor degraders (SERDs) like fulvestrant.
Recent advances in endocrine therapy have primarily focused on the use of combination therapies. For example, combining CDK4/6 inhibitors (such as palbociclib, abemaciclib, and ribociclib) with endocrine therapy has been shown to significantly extend progression-free survival (PFS) and overall survival (OS) while reducing the occurrence of tumor resistance. This combination therapy has become a standard choice for treating HR-positive, HER2-negative advanced breast cancer.
II. Targeted Therapy: Precision Targeting of HER2-Positive Breast Cancer
HER2-positive breast cancer is a rapidly growing subtype with a poorer prognosis. However, significant breakthroughs have been achieved in treating this subtype with the development of targeted therapies. Drugs like trastuzumab, pertuzumab, and T-DM1 are widely used in treating HER2-positive breast cancer.
In recent years, new-generation targeted drugs such as trastuzumab deruxtecan (T-DXd) and small molecule tyrosine kinase inhibitors (TKIs) like lapatinib and neratinib have further improved treatment outcomes. These drugs inhibit tumor cell growth and spread by blocking HER2 signaling pathways. Additionally, they have shown efficacy in patients who have failed previous treatments, offering new options for patients with resistance.
III. Immunotherapy: Activating the Immune System Against Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) lacks estrogen receptors, progesterone receptors, and HER2 expression, making treatment options limited and prognosis poor. In recent years, significant progress has been made in the application of immunotherapy for TNBC.
Programmed death receptor-1 (PD-1) inhibitors and programmed death-ligand 1 (PD-L1) inhibitors (such as pembrolizumab and atezolizumab) have demonstrated positive efficacy in clinical trials, particularly for patients with high PD-L1 expression or high tumor mutation burden (TMB). These immune checkpoint inhibitors activate the patient's immune system to recognize and eliminate cancer cells by blocking immune suppression signals, bringing new hope for treatment.
IV. Emerging Cell Therapies: Pioneering a New Era of Precision, Personalized Treatment
Emerging cell therapies such as CAR-T cell therapy and tumor-infiltrating lymphocyte (TIL) therapy have achieved remarkable success in treating hematologic malignancies and are gradually being introduced into the treatment of solid tumors. Research indicates that these cell therapies hold promise as new treatment options for breast cancer patients, especially those unresponsive to conventional therapies.
CAR-T therapy involves genetically modifying a patient's T cells to recognize and attack cancer cells. Although CAR-T therapy research for breast cancer is still in its early stages, the antitumor activity demonstrated in small-scale clinical trials lays the foundation for future research and application.
V. Integrated Treatment Strategies and Personalized Therapy
With the diversification and personalization of breast cancer treatment, integrated treatment strategies have become a crucial component of treatment decision-making. Medical teams should develop personalized treatment plans based on the patient's specific condition, including tumor type, molecular characteristics, gene mutation status, and overall health. The goal is to maximize treatment efficacy, extend survival, and improve quality of life by combining various treatment modalities such as surgery, radiation therapy, chemotherapy, endocrine therapy, targeted therapy, and immunotherapy.
Conclusion
Breast cancer treatment is evolving towards more precise and personalized approaches. By continuously exploring new treatment methods and optimizing existing ones, we hope to provide more treatment options and better outcomes for breast cancer patients. Faced with this complex and variable disease, patients should work closely with their medical teams, stay informed about the latest treatment advances, and develop the most suitable treatment strategy to improve quality of life and extend survival time.