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已发表论文
HER2 低表达三阴性乳腺癌免疫治疗的进展
Authors Zhang X, Yang D, Lin X, Hu X, Li J, Deng S, Chen Q , Chen X
Received 11 September 2025
Accepted for publication 18 November 2025
Published 1 December 2025 Volume 2025:17 Pages 2985—2995
DOI https://doi.org/10.2147/CMAR.S566797
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Seema Singh
Xiaoyu Zhang,1,2 Dunya Yang,1,2 Xiangwu Lin,1,2 Xinyu Hu,1,2 Jie Li,1,2 Shilong Deng,3,4 Qunxiang Chen,1,2 Xi Chen1,2
1Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350000, People’s Republic of China; 2Department of Oncology, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China; 3Department of Radiotherapy, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350000, People’s Republic of China; 4Department of Radiotherapy, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China
Correspondence: Qunxiang Chen, Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, No. 156, North West 2nd Ring Road, Gulou District, Fuzhou, Fujian, 350000, People’s Republic of China, Tel +86-13459112337 ; +86-13459112337, Email fuzhoucqxiang@163.com Xi Chen, Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, No. 156, North West 2nd Ring Road, Gulou District, Fuzhou, Fujian, 350000, People’s Republic of China, Tel +86-13705045925, Email fuzhoucxi@163.com
Abstract: Triple-negative breast cancer (TNBC) is highly malignant with poor prognosis, and immune checkpoint inhibitors (ICIs) provide only limited survival benefits. A key emerging subtype is HER2 low-expressing TNBC, where HER2 expression influences immune microenvironment, clinical behavior, and therapeutic response. Antibody-drug conjugates (ADCs), particularly trastuzumab deruxtecan (T-DXd), have markedly improved survival and also exert antitumor effects through immune activation. Preclinical data suggest synergy when T-DXd is combined with ICIs. However, HER2-low TNBC often has an immune-suppressive microenvironment, underscoring the need for additional strategies. Tumor vaccines and genomics-driven targeted drugs, such as trastuzumab–α-amanitin conjugates, hold promise in reactivating antitumor immunity. This review summarizes current progress in immunotherapy for HER2 low-expressing TNBC, with emphasis on ADCs, combination regimens, and emerging precision strategies, aiming to inform future research and clinical application.
Keywords: T-DXd, antibody-drug conjugate, immune microenvironment, combination therapy, treatment resistance
1Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350000, People’s Republic of China; 2Department of Oncology, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China; 3Department of Radiotherapy, 900th Hospital of PLA Joint Logistic Support Force, Fuzhou, Fujian, 350000, People’s Republic of China; 4Department of Radiotherapy, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, 350000, People’s Republic of China
Correspondence: Qunxiang Chen, Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, No. 156, North West 2nd Ring Road, Gulou District, Fuzhou, Fujian, 350000, People’s Republic of China, Tel +86-13459112337 ; +86-13459112337, Email fuzhoucqxiang@163.com Xi Chen, Department of Oncology, 900th Hospital of PLA Joint Logistic Support Force, No. 156, North West 2nd Ring Road, Gulou District, Fuzhou, Fujian, 350000, People’s Republic of China, Tel +86-13705045925, Email fuzhoucxi@163.com
Abstract: Triple-negative breast cancer (TNBC) is highly malignant with poor prognosis, and immune checkpoint inhibitors (ICIs) provide only limited survival benefits. A key emerging subtype is HER2 low-expressing TNBC, where HER2 expression influences immune microenvironment, clinical behavior, and therapeutic response. Antibody-drug conjugates (ADCs), particularly trastuzumab deruxtecan (T-DXd), have markedly improved survival and also exert antitumor effects through immune activation. Preclinical data suggest synergy when T-DXd is combined with ICIs. However, HER2-low TNBC often has an immune-suppressive microenvironment, underscoring the need for additional strategies. Tumor vaccines and genomics-driven targeted drugs, such as trastuzumab–α-amanitin conjugates, hold promise in reactivating antitumor immunity. This review summarizes current progress in immunotherapy for HER2 low-expressing TNBC, with emphasis on ADCs, combination regimens, and emerging precision strategies, aiming to inform future research and clinical application.
Keywords: T-DXd, antibody-drug conjugate, immune microenvironment, combination therapy, treatment resistance