新型联合治疗
一项 Ⅱ 期临床试验的数据表明，依维莫司加曲妥珠单抗和紫杉醇在高度耐药的人表皮生长因子受体-2 (HER2) 阳性晚期乳腺癌患者中，表现出了喜人的活性。[118]Hurvitz SA, Dalenc F, Campone M, et al. A phase 2 study of everolimus combined with trastuzumab and paclitaxel in patients with HER2-overexpressing advanced breast cancer that progressed during prior trastuzumab and taxane therapy. Breast Cancer Res Treat. 2013;141:437-446.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824346/http://www.ncbi.nlm.nih.gov/pubmed/24101324?tool=bestpractice.com 曲妥珠单抗 emtansine加帕妥珠单抗对于 HER2-阳性转移性乳腺癌可能是一种有潜力的治疗药物。[119]Diéras V, Harbeck N, Albain K, et al. A phase Ib/II trial of trastuzumab-DM1 (T-DM1) with pertuzumab for patients with HER2-positive, locally advanced or metastatic breast cancer: interim efficacy and safety results. San Antonio Breast Cancer Symposium, San Antonio, TX; December 2010. Abstract P3-14-01.
贝伐珠单抗
贝伐珠单抗是一种针对血管内皮生长因子的人源化单克隆抗体。尽管此前 FDA 批准其与紫杉醇联合用于未曾接受过化疗的转移性 HER2-阴性乳腺癌患者的治疗，[120]Miller K, Wang M, Gralow J, et al. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 2007;357:2666-2676.http://www.nejm.org/doi/full/10.1056/NEJMoa072113http://www.ncbi.nlm.nih.gov/pubmed/18160686?tool=bestpractice.com this approval was withdrawn when 3 studies did not show a survival advantage to its use. [ 
]What are the effects of bevacizumab in women with endocrine refractory or resistant metastatic breast cancer?https://cochranelibrary.com/cca/doi/10.1002/cca.694/full显示答案
阿西替尼
阿西替尼是一种针对血管内皮生长因子受体 1 至 3、血小板源性生长因子受体 β 及 KIT 的小分子酪氨酸激酶抑制剂。已经发现阿西替尼加多西紫杉醇相比多西紫杉醇加安慰剂来说，提高了肿瘤疗效。[121]Rugo HS, Stopeck A, Joy AA, et al. A randomized, double-blind phase II study of the oral tyrosine kinase inhibitor (TKI) axitinib (AG-013736) in combination with docetaxel (DOC) compared to DOC plub placebo (PL) in metastatic breast cancer (MBC). J Clin Oncol. 2007;25(18s):A1003. 目前尚未批准使用。联合紫杉烷类药物用于治疗转移性乳腺癌，可能是有用的。
多（ADP-核糖）聚合酶 (PARP-1) 抑制剂
这类反映药物研发过程中称为“协同杀伤”策略的抑制剂，具有抗肿瘤活性、而无传统化疗药相关的毒性。它们阻断 PARP 蛋白对受损细胞的修复。这类药物对于遗传性乳腺癌及三阴乳腺癌尤其有用。一项针对 PARP-1 抑制剂的 I 期研究表明，该药在与 BRCA1 及 BRCA2 突变有关乳腺癌及其他癌中具有抗肿瘤活性。[122]Fong PC, Boss, DS, Yap TA, et al. Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med. 2009;361:123-134.http://www.nejm.org/doi/full/10.1056/NEJMoa0900212http://www.ncbi.nlm.nih.gov/pubmed/19553641?tool=bestpractice.com 此外，一项针对奥拉帕尼及其他 PARP-1 抑制剂的 II 期试验 BSI-201 结果已经在美国临床肿瘤学会 (ASCO) 上公布了。[117]O'Shaughnessy J. BSI-201 phase II data in metastatic triple-negative breast cancer. Plenary Session, ASCO Annual Meeting, 31 May 2009.
恩替诺特
恩替诺特是一种正在研究中的组蛋白脱乙酰酶抑制剂，已获美国 FDA 批准，可与依西美坦联合使用并作为一种突破性疗法，针对经非甾体类芳香化酶抑制剂治疗后疾病出现进展的绝经后女性治疗局部复发或转移性雌激素受体阳性 (ER+) 乳腺癌。[123]Yardley DA, Ismail-Khan RR, Melichar B, et al. Randomized phase II, double-blind, placebo-controlled study of exemestane with or without entinostat in postmenopausal women with locally recurrent or metastatic estrogen receptor-positive breast cancer progressing on treatment with a nonsteroidal aromatase inhibitor. J Clin Oncol. 2013;31:2128-2135.http://www.ncbi.nlm.nih.gov/pubmed/23650416?tool=bestpractice.com
