Abstract
Triple‑negative breast cancer (TNBC) accounts for 10‑15% of all breast cancer cases. TNBCs lack estrogen and progesterone receptors and express low levels of HER2, and therefore do not respond to hormonal or anti‑HER2 therapies. TNBC is a particularly aggressive form of breast cancer that generally displays poorer prognosis compared to other breast cancer subtypes. TNBC is chemotherapy sensitive, and this treatment remains the standard of care despite its limited benefit. Recent advances with novel agents have been made for specific subgroups with PD‑L1+ tumors or germline Brca‑mutated tumors. However, only a fraction of these patients responds to immune checkpoint or PARP inhibitors and even those who do respond often develop resistance and relapse. Various new agents and combination strategies have been explored to further understand molecular and immunological aspects of TNBC. In this review, we discuss clinical trials in the management of TNBC as well as perspectives for potential future treatments.
Keywords:
triple-negative breast cancer; clinical studies; immunotherapy; DNA-damage response; targeted therapy; therapeutic strategy.
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / pharmacology
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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B7-H1 Antigen / antagonists & inhibitors
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B7-H1 Antigen / metabolism
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BRCA1 Protein / antagonists & inhibitors
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BRCA1 Protein / genetics
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BRCA2 Protein / antagonists & inhibitors
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BRCA2 Protein / genetics
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Breast / pathology
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Breast / surgery
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Chemotherapy, Adjuvant / methods
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Drug Resistance, Neoplasm / genetics
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Female
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Germ-Line Mutation
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Humans
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Immune Checkpoint Inhibitors / pharmacology
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Immune Checkpoint Inhibitors / therapeutic use
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Mastectomy*
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Neoplasm Recurrence, Local / epidemiology*
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Neoplasm Recurrence, Local / genetics
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Neoplasm Recurrence, Local / immunology
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Neoplasm Recurrence, Local / prevention & control
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Poly(ADP-ribose) Polymerase Inhibitors / pharmacology
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Poly(ADP-ribose) Polymerase Inhibitors / therapeutic use
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Prognosis
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Progression-Free Survival
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Triple Negative Breast Neoplasms / genetics
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Triple Negative Breast Neoplasms / immunology
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Triple Negative Breast Neoplasms / mortality
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Triple Negative Breast Neoplasms / therapy*
Substances
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B7-H1 Antigen
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BRCA1 Protein
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BRCA1 protein, human
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BRCA2 Protein
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BRCA2 protein, human
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CD274 protein, human
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Immune Checkpoint Inhibitors
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Poly(ADP-ribose) Polymerase Inhibitors