Triple-negative breast cancer: treatment challenges and solutions

• Published in: Breast cancer targets and therapy Vol. 8; no. Issue 1; pp. 93 - 107
• Main Authors: Collignon, Joëlle, Lousberg, Laurence, Schroeder, Hélène, Jerusalem, Guy
• Format: Journal Article Web Resource
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2016; Taylor & Francis Ltd; Dove Medical Press
• Subjects: androgen receptor; Androgen receptors; Anopheles; Anthracyclines; Bevacizumab; BRCA1/2 mutation; Breast cancer; Cancer therapies; Cancer treatment; Carboplatin; Chemotherapy; Clinical trials; Cyclophosphamide; Dasatinib; Deoxyribonucleic acid; DNA; DNA methylation; Drug therapy; Epidermal growth factor; Estrogens; Gene expression; Genotype & phenotype; Human health sciences; Immunotherapy; Ionizing radiation; Kinases; Ligands; Medical prognosis; molecular subtype; Mutation; Oncologie; oncology; Original Research; Phenols (Class of compounds); platinum-based chemotherapy; Progesterone; Prognosis; Sciences de la santé humaine; Sex hormones; targeted therapy; triple-negative breast cancer; Tumors; Vascular endothelial growth factor; Womens health; Canada; Belgium; platinum-based chemotherapy; targeted therapy; triple-negative breast cancer; androgen receptor; BRCA1/2 mutation; molecular subtype
• ISSN: 1179-1314; 1179-1314
• DOI: 10.2147/bctt.s69488

Triple-negative breast cancers (TNBCs) are defined by the absence of estrogen and progesterone receptors and the absence of HER2 overexpression. These cancers represent a heterogeneous breast cancer subtype with a poor prognosis. Few systemic treatment options exist besides the use of chemotherapy (CT). The heterogeneity of the disease has limited the successful development of targeted therapy in unselected patient populations. Currently, there are no approved targeted therapies for TNBC. However, intense research is ongoing to identify specific targets and develop additional and better systemic treatment options. Standard adjuvant and neoadjuvant regimens include anthracyclines, cyclophosphamide, and taxanes. Platinum-based CT has been proposed as another CT option of interest in TNBC. We review the role of this therapy in general, and particularly in patients carrying BRCA germ-line mutations. Available data concerning the role of platinum-based CT in TNBC were acquired primarily in the neoadjuvant setting. The routine use of platinum-based CT is not yet recommended by available guidelines. Many studies have reported the molecular characterization of TNBCs. Several actionable targets have been identified. Novel therapeutic strategies are currently being tested in clinical trials based on promising results observed in preclinical studies. These targets include androgen receptor, EGFR, PARP, FGFR, and the angiogenic pathway. We review the recent data on experimental drugs in this field. We also discuss the recent data concerning immunologic checkpoint inhibitors.