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上海中医药大学 附属龙华医院,上海 200030
Published:05 April 2023,
Published Online:21 June 2022,
Received:19 April 2022,
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李斐斐,史有阳,张洋等.基于HER-2阳性乳腺癌治疗难点探讨中医药治疗特色及研究进展[J].中国实验方剂学杂志,2023,29(07):237-243.
LI Feifei,SHI Youyang,ZHANG Yang,et al.Characteristics and Research Progress of Traditional Chinese Medicine in Treatment of HER-2-Positive Breast Cancer: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):237-243.
李斐斐,史有阳,张洋等.基于HER-2阳性乳腺癌治疗难点探讨中医药治疗特色及研究进展[J].中国实验方剂学杂志,2023,29(07):237-243. DOI: 10.13422/j.cnki.syfjx.20221725.
LI Feifei,SHI Youyang,ZHANG Yang,et al.Characteristics and Research Progress of Traditional Chinese Medicine in Treatment of HER-2-Positive Breast Cancer: A Review[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(07):237-243. DOI: 10.13422/j.cnki.syfjx.20221725.
人表皮生长因子受体-2(HER-2)阳性乳腺癌因HER-2的过表达而具有高侵袭转移潜能,导致患者的不良预后。靶向HER-2治疗药物如曲妥珠单抗、帕妥珠单抗、恩美曲妥珠单抗的上市显著延长了患者的无病生存期(DFS)。然而,频发的多药耐药、肿瘤的复发转移及辅助治疗带来的心脏损伤、胃肠道不适等不良反应,仍然是HER-2阳性乳腺癌的治疗挑战。中医药对于乳腺癌的认识源远流长,在几千年的传承与创新发展中,已逐步形成具有中医药特色的规范化治疗体系,在乳腺癌治疗中表现出独特优势及显著疗效。中医药理论指导下的“辨证施治”“分期分型论治”“因人制宜”“根据癌毒邪气从化的不同分脏腑论治”等治疗原则,与现代个体化精准治疗的理念不谋而合。该文基于HER-2阳性乳腺癌中存在的“多药耐药、肿瘤复发转移、心脏毒性、胃肠道不适”等治疗难点,从中医学对乳腺癌术后“扶正兼以祛邪、辨证施治”的基本治疗理念出发,梳理归纳中医药在“逆转HER-2阳性乳腺癌靶向药物的多药耐药、协同增效、抑制乳腺癌复发转移、延长患者无病生存期、改善患者预后、减轻辅助治疗所带来的不良反应、提高患者生活质量”等方面的治疗特色及研究进展,旨在为HER-2阳性乳腺癌的中医药治疗提供参考。
Human epidermal growth factor receptor-2 (HER-2)-positive breast cancer has higher predilection to metastasize and invade other organs, leading to poor prognosis. The anti-HER-2 drugs, such as trastuzumab, pertuzumab, and trastuzumab emtansinehas, can remarkably prolong the disease free survival (DFS) of patients. However, frequent multidrug resistance, tumor recurrence and metastasis, and adverse reactions such as cardiotoxicity and gastrointestinal discomfort caused by adjuvant therapy are still challenges for the treatment of HER-2-positive breast cancer. The understanding of breast cancer in traditional Chinese medicine (TCM) has a long history. In thousands of years of inheritance and innovation, a standardized treatment system with TCM characteristics has been gradually formed, which shows unique advantages and significant curative effects in breast cancer treatment. The treatment principles of ''treatment based on syndrome differentiation'', ''treatment based on stages and types'', ''treatment according to individual conditions'', and ''treatment of different viscera and viscera based on the toxin and pathogen'' are closely related to the precise treatment concept. In view of the challenges in the treatment of HER-2-positive breast cancer, such as multidrug resistance, tumor recurrence and metastasis, cardiotoxicity, and gastrointestinal discomfort, this paper summarizes the characteristics of TCM in reversing the multidrug resistance, inhibiting tumor recurrence and metastasis, prolonging DFS, improving prognosis, reducing adverse reactions caused by adjuvant therapy, and improving the quality of life after breast cancer surgery according to the principles of reinforcing healthy Qi and eliminating pathogen, and treatment based on syndrome differentiation. This article is expected to serve as a reference for TCM treatment of HER-2 positive breast cancer.
中医药人表皮生长因子-2(HER-2)阳性乳腺癌耐药复发转移不良反应
traditional Chinese medicinehuman epidermal growth factor receptor -2 (HER-2)-positive breast cancerdrug resistancerecurrence and metastasisadverse reactions
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