Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges
Triple negative breast cancer (TNBC) is an aggressive breast cancer with historically poor outcomes, primarily due to the lack of effective targeted therapies. The tumor molecular heterogeneity of TNBC has been well recognized, yet molecular subtype driven therapy remains lacking. While neoadjuvant...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/12/6/1404 |
| _version_ | 1797566677994438656 |
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| author | Jin Sun Lee Susan E. Yost Yuan Yuan |
| author_facet | Jin Sun Lee Susan E. Yost Yuan Yuan |
| author_sort | Jin Sun Lee |
| collection | DOAJ |
| description | Triple negative breast cancer (TNBC) is an aggressive breast cancer with historically poor outcomes, primarily due to the lack of effective targeted therapies. The tumor molecular heterogeneity of TNBC has been well recognized, yet molecular subtype driven therapy remains lacking. While neoadjuvant anthracycline and taxane-based chemotherapy remains the standard of care for early stage TNBC, the optimal chemotherapy regimen is debatable. The addition of carboplatin to anthracycline, cyclophosphamide, and taxane (ACT) regimen is associated with improved complete pathologic response (pCR). Immune checkpoint inhibitor (ICI) combinations significantly increase pCR in TNBC. Increased tumor infiltrating lymphocyte (TILs) or the presence of DNA repair deficiency (DRD) mutation is associated with increased pCR. Other targets, such as poly-ADP-ribosyl polymerase inhibitors (PARPi) and Phosphatidylinositol-3-kinase/Protein Kinase B/mammalian target of rapamycin (PI3K-AKT-mTOR) pathway inhibitors, are being evaluated in the neoadjuvant setting. This review examines recent progress in neoadjuvant therapy of TNBC, including platinum, ICI, PARPi, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) pathway targeted therapies, and novel tumor microenvironment (TME) targeted therapy, in addition to biomarkers for the prediction of pCR. |
| first_indexed | 2024-03-10T19:29:52Z |
| format | Article |
| id | doaj.art-a12699cf764045cf96fcd36f1fac7eae |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T19:29:52Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a12699cf764045cf96fcd36f1fac7eae2023-11-20T02:12:31ZengMDPI AGCancers2072-66942020-05-01126140410.3390/cancers12061404Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and ChallengesJin Sun Lee0Susan E. Yost1Yuan Yuan2Department of Medical Oncology & Molecular Therapeutics, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USADepartment of Medical Oncology & Molecular Therapeutics, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USADepartment of Medical Oncology & Molecular Therapeutics, City of Hope Comprehensive Cancer Center and Beckman Research Institute, Duarte, CA 91010, USATriple negative breast cancer (TNBC) is an aggressive breast cancer with historically poor outcomes, primarily due to the lack of effective targeted therapies. The tumor molecular heterogeneity of TNBC has been well recognized, yet molecular subtype driven therapy remains lacking. While neoadjuvant anthracycline and taxane-based chemotherapy remains the standard of care for early stage TNBC, the optimal chemotherapy regimen is debatable. The addition of carboplatin to anthracycline, cyclophosphamide, and taxane (ACT) regimen is associated with improved complete pathologic response (pCR). Immune checkpoint inhibitor (ICI) combinations significantly increase pCR in TNBC. Increased tumor infiltrating lymphocyte (TILs) or the presence of DNA repair deficiency (DRD) mutation is associated with increased pCR. Other targets, such as poly-ADP-ribosyl polymerase inhibitors (PARPi) and Phosphatidylinositol-3-kinase/Protein Kinase B/mammalian target of rapamycin (PI3K-AKT-mTOR) pathway inhibitors, are being evaluated in the neoadjuvant setting. This review examines recent progress in neoadjuvant therapy of TNBC, including platinum, ICI, PARPi, phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) pathway targeted therapies, and novel tumor microenvironment (TME) targeted therapy, in addition to biomarkers for the prediction of pCR.https://www.mdpi.com/2072-6694/12/6/1404Triple negative breast cancerneoadjuvant treatmenttargeted treatment |
| spellingShingle | Jin Sun Lee Susan E. Yost Yuan Yuan Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges Cancers Triple negative breast cancer neoadjuvant treatment targeted treatment |
| title | Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges |
| title_full | Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges |
| title_fullStr | Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges |
| title_full_unstemmed | Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges |
| title_short | Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges |
| title_sort | neoadjuvant treatment for triple negative breast cancer recent progresses and challenges |
| topic | Triple negative breast cancer neoadjuvant treatment targeted treatment |
| url | https://www.mdpi.com/2072-6694/12/6/1404 |
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