Advances in the Management of Early-Stage Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) is a subtype of breast cancer with both inter- and intratumor heterogeneity, thought to result in a more aggressive course and worse outcomes. Neoadjuvant therapy (NAT) has become the preferred treatment modality of early-stage TNBC as it allows for the downstagi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/15/12478 |
| _version_ | 1797586586320240640 |
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| author | Prarthna V. Bhardwaj Yue Wang Elizabeth Brunk Philip M. Spanheimer Yara G. Abdou |
| author_facet | Prarthna V. Bhardwaj Yue Wang Elizabeth Brunk Philip M. Spanheimer Yara G. Abdou |
| author_sort | Prarthna V. Bhardwaj |
| collection | DOAJ |
| description | Triple-negative breast cancer (TNBC) is a subtype of breast cancer with both inter- and intratumor heterogeneity, thought to result in a more aggressive course and worse outcomes. Neoadjuvant therapy (NAT) has become the preferred treatment modality of early-stage TNBC as it allows for the downstaging of tumors in the breast and axilla, monitoring early treatment response, and most importantly, provides important prognostic information that is essential to determining post-surgical therapies to improve outcomes. It focuses on combinations of systemic drugs to optimize pathologic complete response (pCR). Excellent response to NAT has allowed surgical de-escalation in ideal candidates. Further, treatment algorithms guide the systemic management of patients based on their pCR status following surgery. The expanding knowledge of molecular pathways, genomic sequencing, and the immunological profile of TNBC has led to the use of immune checkpoint inhibitors and targeted agents, including PARP inhibitors, further revolutionizing the therapeutic landscape of this clinical entity. However, subgroups most likely to benefit from these novel approaches in TNBC remain elusive and are being extensively studied. In this review, we describe current practices and promising therapeutic options on the horizon for TNBC, surgical advances, and future trends in molecular determinants of response to therapy in early-stage TNBC. |
| first_indexed | 2024-03-11T00:24:10Z |
| format | Article |
| id | doaj.art-2a6e8d53f2c74ce0a271ddd45ffe02ec |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T00:24:10Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-2a6e8d53f2c74ce0a271ddd45ffe02ec2023-11-18T23:05:34ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-08-0124151247810.3390/ijms241512478Advances in the Management of Early-Stage Triple-Negative Breast CancerPrarthna V. Bhardwaj0Yue Wang1Elizabeth Brunk2Philip M. Spanheimer3Yara G. Abdou4Division of Hematology-Oncology, University of Massachusetts Chan Medical School—Baystate, Springfield, MA 01199, USADepartment of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USALineberger Comprehensive Cancer Center, UNC Chapel Hill, NC 27599, USALineberger Comprehensive Cancer Center, UNC Chapel Hill, NC 27599, USATriple-negative breast cancer (TNBC) is a subtype of breast cancer with both inter- and intratumor heterogeneity, thought to result in a more aggressive course and worse outcomes. Neoadjuvant therapy (NAT) has become the preferred treatment modality of early-stage TNBC as it allows for the downstaging of tumors in the breast and axilla, monitoring early treatment response, and most importantly, provides important prognostic information that is essential to determining post-surgical therapies to improve outcomes. It focuses on combinations of systemic drugs to optimize pathologic complete response (pCR). Excellent response to NAT has allowed surgical de-escalation in ideal candidates. Further, treatment algorithms guide the systemic management of patients based on their pCR status following surgery. The expanding knowledge of molecular pathways, genomic sequencing, and the immunological profile of TNBC has led to the use of immune checkpoint inhibitors and targeted agents, including PARP inhibitors, further revolutionizing the therapeutic landscape of this clinical entity. However, subgroups most likely to benefit from these novel approaches in TNBC remain elusive and are being extensively studied. In this review, we describe current practices and promising therapeutic options on the horizon for TNBC, surgical advances, and future trends in molecular determinants of response to therapy in early-stage TNBC.https://www.mdpi.com/1422-0067/24/15/12478breast cancerbreast surgeryearly-stage TNBCimmunotherapyneoadjuvant chemotherapyPARP inhibitors |
| spellingShingle | Prarthna V. Bhardwaj Yue Wang Elizabeth Brunk Philip M. Spanheimer Yara G. Abdou Advances in the Management of Early-Stage Triple-Negative Breast Cancer International Journal of Molecular Sciences breast cancer breast surgery early-stage TNBC immunotherapy neoadjuvant chemotherapy PARP inhibitors |
| title | Advances in the Management of Early-Stage Triple-Negative Breast Cancer |
| title_full | Advances in the Management of Early-Stage Triple-Negative Breast Cancer |
| title_fullStr | Advances in the Management of Early-Stage Triple-Negative Breast Cancer |
| title_full_unstemmed | Advances in the Management of Early-Stage Triple-Negative Breast Cancer |
| title_short | Advances in the Management of Early-Stage Triple-Negative Breast Cancer |
| title_sort | advances in the management of early stage triple negative breast cancer |
| topic | breast cancer breast surgery early-stage TNBC immunotherapy neoadjuvant chemotherapy PARP inhibitors |
| url | https://www.mdpi.com/1422-0067/24/15/12478 |
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