2025年乳腺癌精准治疗的进展与展望OA

Precision treatment in breast cancer is transitioning from a phase of classification-based therapy based on molecular subtypes to a new era of biomarker-driven individualized management.In the realm of human epidermal growth factor receptor 2(HER2)-positive breast cancer,antibody-drug conjugates(ADCs)and small-molecule tyrosine kinase inhibitors(TKIs)continue to drive therapeutic innovation.Despite their remarkable efficacy,the complex mechanisms of drug resistance remain a central challenge.Future progress is expected to rely on novel ADCs,bispecific antibodies,and innovative combination strategies.For hormone receptor(HR)-positive/HER2-negative breast cancer,treatment has fully entered the"targeted-plus"era,with CDK4/6 inhibitors combined with endocrine therapy established as the first-line standard for advanced disease.To address resistance to CDK4/6 inhibitors,targeted options include inhibitors of the phosphoinositide3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway,novel oral selective estrogen receptor degraders(SERDs),as well as novel ADCs,offering diverse and precise therapeutic alternatives.Triple-negative breast cancer has moved beyond the"untargetable"dilemma,thanks to the successful introduction of immune checkpoint inhibitors(ICIs)and novel anti-HER2 and trophoblast cell surface antigen-2(TROP-2)ADCs.Innovative combination strategies involving drugs with different mechanisms of action demonstrate the potential to overcome current therapeutic limitations,bringing new hope to patients.Precision medicine in breast cancer is evolving toward a more integrated paradigm that incorporates refined molecular subtyping,dynamic liquid biopsy monitoring,artificial intelligence-enhanced multi-omics analytics,digital health technologies,and chronic disease management frameworks.This convergence will facilitate the establishment of a holistic,highly individualized health management system.Through ongoing improvements in the accessibility of innovative therapeutics,the development of interoperable data platforms,and enhanced multidisciplinary collaboration-collectively accelerating the optimization and broader implementation of precision oncology in clinical practice.This review systematically summarizes the current advances and future directions in this field.