Current Therapeutic Strategies for Metastatic Triple-Negative Breast Cancer: From Pharmacists’ Perspective

Abstract

Triple-negative breast cancer (TNBC) is characterized by its high invasiveness, high metastasis and poor prognosis. More than one-third of patients with TNBC will present with recurrence or distant metastasis. Chemotherapy based on anthracyclines and taxanes is the standard treatment strategy for metastatic TNBC (mTNBC). Due to the lack of expression of progesterone receptor, estrogen receptor, and human epidermal growth factor receptor 2, therapies targeting these receptors are ineffective for mTNBC, thus special treatment strategies are required. In recent years, the development of new chemotherapy drugs, targeted drugs and immunotherapy drugs offers good prospects for the treatment of mTNBC. However, as these drugs are still in their infancy, several problems regarding the optimization and management of the clinical application of these new options should be considered. Pharmacists can play an important role in drug selection, drug therapy management, the management of adverse drug reactions and pharmacoeconomic evaluation. In this review, we summarized traditional treatment strategies, and discussed the efficacy and safety of novel agents approved in the last ten years and combination regimens for mTNBC, with the aim of providing management strategies for the clinical management of mTNBC from pharmacists’ perspective.

CCAAT enhancer binding protein delta activates vesicle associated membrane protein 3 transcription to enhance chemoresistance and extracellular PD-L1 expression in triple-negative breast cancer

“…It constitutes roughly 15–20% of all breast cancer cases [ 3 ]. Owing to the negative expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2, conventional therapies targeting these receptors are therefore ineffective for TNBC, leaving taxanes (such as paclitaxel; PTX)- and anthracyclines-based chemotherapy as the standard regimen [ 4 , 5 ]. For patients with metastatic disease, chemotherapy has been suggested as the primary therapeutic option [ 6 , 7 ].…”

Aptamer-Based Strategies to Boost Immunotherapy in TNBC

“…The limited options of molecular therapies and the highly heterogeneous nature of these tumors make TNBC the most challenging BC to treat. To date, the standard of care for both early and advanced TNBC remains chemotherapy, generally using combined regimens of taxane, anthracycline, cyclophosphamide, cisplatin, and fluorouracil [ 7 , 8 ]. Unfortunately, chemotherapy efficacy is limited by the high toxicity toward normal cells [ 9 ].…”