通过HER2表达和结合的丧失来实现对Trastuzumab Deruxtecan (T-DXd) 的抵抗
Wanyi Chen1, Avantika Gupta2, Nicholas Mai3
1Weill Cornell Medicine, New York, NY, United States.
Cancer discovery
|November 10, 2025
概括
转移性乳腺癌中对T-DXd的耐药性通常涉及减少HER2表达或突变. 将T-DXd与TROP2-定向抗体-药物联合体结合起来,可以通过改善药物输送来克服这种抵抗.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 分子生物学分子生物学
背景情况:
- 特拉斯图祖马布德鲁克斯泰干 (T-DXd) 显示在HER2-阳性和HER2-低转移性乳腺癌中具有临床益处.
- 对T-DXd的治疗耐药性随着时间的推移而发展,其机制往往不太清楚.
研究的目的:
- 研究转移性乳腺癌中T-DXd耐药性的分子机制.
- 确定克服T-DXd抵抗的策略.
主要方法:
- 对T-DXd前后患者样本的分子表征.
- 同源模型系统用于研究HER2表达和T-DXd灵敏度.
- 用T-DXd和TROP2-定向抗体-药物联合体 (ADCs) 进行组合治疗的评估.
主要成果:
- 49%的患者在进展时显示HER2表达减少,52%的患者显示完全失去HER2.
- 降低HER2表达与降低T-DXd内化和增加药物IC50.0相关.
- 在trastuzumab的结合接口中发现了HER2突变 (V597M,P593R),从而产生抗药性.
- 低剂量T-DXd与TROP2导向的ADC相结合,均地传递DXd有效载荷,克服 HER2损失介导的抵抗.
结论:
- 减少HER2表达和特定的HER2突变是T-DXd耐药性的关键机制.
- 与TROP2导向的ADC结合治疗是克服转移性乳腺癌中T-DXd耐药性的有希望的策略.
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