The advance of adjuvant treatment for triple-negative breast cancer

Abstract

Triple-negative breast cancer (TNBC) is a subtype of breast cancer characterized by its highly aggressive behavior, early recurrence, and poor outcomes, when compared with other subtypes. Due to the absence of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression, TNBC lacks meaningful biomarkers and an effective therapeutic strategy. Chemotherapy remains the main adjuvant treatment for patients with TNBC. Anthracycline/taxane-based regimens are the standard of care in adjuvant settings. The addition of capecitabine or platinum may offer extra benefits to patients with TNBC, but at the cost of increased toxicity or adverse events. Dose-dense chemotherapy may enhance treatment efficacy in patients who are able to tolerate the treatment regimen, especially in high-risk patients. As a heterogenous disease, TNBC can be classified into several molecular subtypes according to genomic or transcriptional features, which may indicate potential targets for more precise and individualized treatment strategies. With our increased understanding of signal pathways associated with TNBC, as well as the discovery of novel biomarkers indicative of TNBC prognosis, several new therapeutic options are under investigation, and some have already reported good results. In this review, we summarized the current conventional therapeutic strategies and emerging clinical trials regarding adjuvant treatment for TNBC. Furthermore, we evaluated the prognostic value of several potential targets and the progress of targeted therapy in TNBC, both in neoadjuvant and adjuvant settings. KEYWORDSTriple-negative breast cancer; adjuvant chemotherapy; targeted therapy; prognostic factors Adjuvant treatment for TNBCTNBC lacks ER, PR, and HER2 expression and responds poorly towards endocrine and anti-HER2 therapies. Chemotherapy is therefore the preferred treatment for TNBC patients in neoadjuvant, adjuvant, and metastatic settings according to numerous clinical guidelines (e.g., the American Society of Clinical Oncology, the National Comprehensive Cancer Network, and the European Society for Medical Oncology).There is no evidence yet to indicate that a specific chemotherapy

The Physiological Mechanisms of Triple Negative Breast Cancer in African American Women

“…39 Patients with BRCA1/2 mutations and TNBC are more likely to have PARP DNA repair dysregulation or deficiencies. 40 PARP inhibitors (olaparib) combined with PIK3 antagonists (Novartis) are currently being explored as drugs that promote apoptosis and DNA repair. 39 Immune modulation to target cancer cells is an emerging topic for TNBC.…”

Triple-Negative Breast Cancer: A Review of Current Curative Intent Therapies

“…However, in the subgroup of tumors with mutations in the PIK3CA/AKT1/PTEN pathway, a pCR rate of 39% with ipatasertib was seen, compared to just 9% in the placebo arm. Another potential treatment strategy is the androgen receptor (AR), which is expressed in many TNBC patients, although the data supporting the use of treatments such as enzalutamide or abiraterone are extremely limited and primarily only in the metastatic setting [ 24 ]. Therefore, these treatments should not be used in the curative-intent setting outside of a clinical trial at this time.…”

“…Prevents the androgen receptor from translocating through the cell, preventing DNA transcription MDV3100-11 [24] Pregnenolone Analogue Abiraterone Suppresses CPY17A1-mediated androgen synthesis and direct AR-inhibitory properties UCBG 12-1 [24] Antibody-Drug Conjugates…”

Rationale and Clinical Research Progress on PD-1/PD-L1-Based Immunotherapy for Metastatic Triple-Negative Breast Cancer

“…The average pathologically complete response (pCR) to mTNBC with multi-drug combination chemotherapy regimen is about 30–40% [ 3 ]. In summary, the benefit of chemotherapy for patients with mTNBC is not promising [ 4 , 5 ]. The search for treatments with high clearance, good targeting, and few side effects has become a major focus of medical research.…”