基础医学与临床 ›› 2025, Vol. 45 ›› Issue (12): 1662-1667.doi: 10.16352/j.issn.1001-6325.2025.12.1662

• 短篇综述 • 上一篇    下一篇

乳腺癌代谢机制与免疫微环境靶向的协同治疗进展

张彦池1, 施俊琦2, 张一君1, 段佳文1, 刘进宇1, 张丽燕1, 梁晚平1*   

  1. 河北北方学院附属第一医院 1.乳腺外科; 2.麻醉科,河北 张家口 075000
  • 收稿日期:2025-07-18 修回日期:2025-10-14 出版日期:2025-12-05 发布日期:2025-11-25
  • 通讯作者: *15530396549@163.com
  • 基金资助:
    河北省卫生健康委医学科学研究重点课题计划(20231095)

Advances in synergistic therapies targeting metabolic mechanisms and the immune microenvironment in breast cancer

ZHANG Yanchi1, SHI Junqi2, ZHANG Yijun1, DUAN Jiawen1, LIU Jinyu1, ZHANG Liyan1, LIANG Wanping1*   

  1. 1. Department of Breast Surgery; 2. Department of Anesthesiology, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2025-07-18 Revised:2025-10-14 Online:2025-12-05 Published:2025-11-25
  • Contact: *15530396549@163.com

摘要: 本文系统综述乳腺癌独特的代谢机制与肿瘤局部微环境间相互作用及其靶向治疗最新进展。乳腺癌的代谢重编程与肿瘤微环境(TME)的互作构成其恶性进展和治疗抵抗的重要基础。乳腺癌细胞通过Warburg效应、脂肪酸及氨基酸代谢重塑能量供应,而TME中的免疫细胞、成纤维细胞和酸性环境则通过代谢耦联促进免疫逃逸与耐药性。传统靶向关键代谢酶策略虽具价值,但难以克服代谢适应性。近年来,代谢与免疫协同治疗成为新方向:通过抑制乳酸积累、恢复T细胞功能并调控肿瘤相关巨噬细胞极化和肿瘤相关成纤维细胞募集,可重塑免疫微环境并增强免疫治疗效应。代谢组学、单细胞测序等技术的应用进一步揭示了乳腺癌异质性,为个体化精准治疗提供依据。未来的挑战包括耐药机制解析、高选择性代谢抑制剂开发以及TME多组学诊断整合的联合方案设计。

关键词: 乳腺癌, 代谢重编程, 肿瘤微环境, 肿瘤代谢, 免疫抑制

Abstract: This review systematically summarizes the unique metabolic mechanisms of breast cancer, their interactions with the tumor microenvironment (TME), and the latest advances in targeted therapies. The interplay between metabolic reprogramming and the TME underpins malignant progression and therapeutic resistance. Breast cancer cells reshape energy supply through the Warburg effect, aberrant fatty acid synthesis, and amino acid metabolism, while immune cells, fibroblasts, and the acidic milieu within the TME promote immune evasion and drug resistance via metabolic coupling. Although traditional strategies targeting key metabolic enzymes remain valuable, they are often insufficient to overcome metabolic adaptability. In recent years, combined metabolic and immunotherapeutic approaches have emerged as promising strategies: by reducing lactate accumulation, restoring T-cell function, and reprogramming tumor-associated macrophages and cancer-associated fibroblasts, these therapies can remodel the immunosuppressive microenvironment and enhance immunotherapy efficacy. The application of metabolomics and single-cell sequencing further elucidates breast cancer heterogeneity, providing a basis for individualized precision treatment. Future challenges include deciphering resistance mechanisms, developing highly selective metabolic inhibitors, and designing integrated multi-omics-based therapeutic regimens.

Key words: breast cancer, metabolic reprogramming, tumor microenvironment, tumor metabolism, immune suppression

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