21世纪经济报道记者 闫硕 乳腺癌是威胁我国女性健康最常见的恶性肿瘤之一。其中，激素受体阳性/HER2阴性（HR+/HER2-）在 乳腺癌确诊病例中约占70%，是最常见的亚型。 该亚型生物学行为相对惰性，早期可沟通手术联合内分泌治疗获得良好预后，然而一旦进入晚期阶段， 治疗窗口急剧缩窄。对于HR+/HER2-晚期乳腺癌患者来说，CDK4/6抑制剂联合内分泌治疗成为最新指 南认可的一线治疗标准方案。 尽管部分患者治疗效果较好，但整体5年生存不足50%，一些患者最终仍会出现耐药，面临着疾病复发 和进展的情况。"在HR+/HER2-晚期乳腺癌患者的耐药上，最关键的就是PAM通路 （PI3K/AKT/mTOR）的突变，在后续的治疗中，PAM通路抑制剂联合内分泌治疗，会达到逆转耐药的 疗效，达到更好、更长地控制肿瘤的效果。"中国临床肿瘤学会（CSCO）副理事长、江苏省人民医院 副院长、江苏省妇幼保健院执行副院长殷咏梅教授向21世纪经济报道指出。 西安交通大学药学院副院长方宇教授向21世纪经济报道指出，HR+/HER2-晚期乳腺癌患者在耐药后治 疗费用比较高，需要多层次的医疗保障体系作为支撑。事实上，对于此类创新药物，我 ...

分型精准治疗为代表的治疗理念，大大提升了患者预后，已成为晚期乳腺癌的主流治疗理念。殷咏梅表 示，目前针对PAM通路突变的一些靶向药物联合内分泌治疗，已经在后续治疗上发挥了很大的作用。 "HR+/HER2-乳腺癌患者如果能够早期诊断、早期治疗，预后比较好，但部分患者确诊时已经是局部晚 期，有20%-30%的复发可能性。"殷咏梅表示，过去缺乏内分泌治疗的靶向药物，这部分人群五年生存 率只有20%-30%。在CDK4/6抑制剂问世后，五年生存率有所提升，但部分晚期乳腺癌患者会对CDK4/6 抑制剂和目前的内分泌疗法产生耐药。 "一旦出现耐药，患者的预后会很差。对于这部分患者而言，是否有更好的治疗药物，是目前我们最关 心的问题。"殷咏梅提及，内分泌治疗原发耐药患者中，约60%以上可能会有PAM通路的突变，尤其是 早复发的患者，即辅助治疗期间出现复发和转移，或者在辅助治疗五年结束以后还不到一年之内复发的 患者。PAM通路的突变，会对肿瘤的发生、进展等方面产生促进作用。因此，内分泌治疗发生耐药 后，最关键的是尽早做PAM通路基因检测。针对PAM通路上有相关突变的，后续就会根据患者的检验 结果进行更精准的治疗。 新京报讯( ...

Core Viewpoint - The pharmaceutical sector is experiencing moderate revenue growth and enhanced profit elasticity in 2024, driven by a stabilizing policy environment and internal structural optimization [1][5]. Revenue and Profit Performance - In 2024, 89 listed companies achieved total revenue of 391.7 billion yuan, a slight increase of 1% year-on-year; net profit attributable to shareholders reached 42.4 billion yuan, with a growth rate of 8.2% [1]. - Quarterly revenue growth rates for 2024 were 1.6%, 2.7%, 3.3%, and -0.3%, while net profit growth remained between 4.8% and 13%, peaking at 13% in Q2 [1]. - In Q1 2025, revenue declined by 3.1% to 96.62 billion yuan, and net profit slightly decreased by 1.1% to 12.56 billion yuan, indicating short-term market demand fluctuations [1]. Profitability Indicators - The sector's gross margin increased by 0.6 percentage points to 55%, and net margin rose by 0.8 percentage points to 12% in 2024 [2]. - The sales expense ratio decreased by 1 percentage point to 40%, with the most significant reduction occurring in Q2, contributing to improved profitability [2]. - In Q1 2025, gross margin further increased to 55.1%, and net profit margin reached a record high of 13% [2]. Market Competition Landscape - The industry is witnessing a significant increase in concentration, with the top 20 companies contributing 293.1 billion yuan, accounting for approximately 75% of total revenue in 2024 [2][3]. - The top 10 companies generated 226.5 billion yuan, representing 58% of the sector's revenue, with major players like Huadong Medicine, Fosun Pharma, and Heng Rui Medicine each exceeding 30 billion yuan in revenue [2]. Innovation Drug Sector - The innovative drug sub-sector is a key growth driver, with 57 A-share innovative drug companies generating 309.7 billion yuan in revenue, a year-on-year increase of 9.4%, and net profit rising by 65.1% [3]. - Heng Rui Medicine led with over 8 billion yuan in net profit, while BeiGene's sales of Zepzelca exceeded 5 billion yuan in overseas markets [3]. R&D Investment Trends - In 2024, R&D expenditures in the innovative drug sector totaled 54.1 billion yuan, a 5.2% increase, but the R&D expense ratio decreased to 17.5% [4]. - In Q1 2025, the innovative drug sector saw a slight revenue decline of 0.3% to 68.09 billion yuan, while net profit grew by 5.4% to 7.96 billion yuan [4]. Overall Industry Outlook - The pharmaceutical sector is characterized by improved profit quality and differentiated growth momentum amid a complex environment of policy stabilization and intensified market competition [5]. - Companies with strong R&D capabilities, cost control advantages, and international perspectives are expected to thrive, while those relying on traditional generics may face greater challenges [5].