Abstract
Triple-negative breast cancer (TNBC) has a poor prognosis compared to other subtypes and lacks common therapeutic targets, including HER 2 and the estrogen and progesterone receptors. The clinicopathological heterogeneity of the disease and limited treatment options make clinical management particularly challenging. Here we present the results of a survey of Canadian clinical oncologists regarding treatment of TNBC, and review recent and ongoing clinical research in this area. Our survey results show that the majority of respondents use a combination of anthracyclines-taxanes as adjuvant therapy for early TNBC. For the first-line treatment of metastatic TNBC, most clinicians recommend taxanes, while single agent capecitabine and platinum-based therapies are more common for subsequent lines of therapy. Despite the ongoing development of novel targeted therapies, chemotherapy remains the mainstay of treatment for TNBC.
Highlights
Triple-negative (TN) breast cancers are heterogeneous, with significant variability in morphological and pathological features
Despite the poor prognosis of Triple-negative breast cancer (TNBC), studies have demonstrated that TNBC is more responsive to chemotherapy than other molecular subtypes[10,17,18]
Since common treatments for hormone receptor-positive and/or human epidermal growth factor receptor 2 (HER2)-positive breast cancers are ineffective in TN disease, both National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) guidelines recommend the use of third-generation chemotherapy, similar to that offered to other high-risk patients[12,19]
Summary
Triple-negative (TN) breast cancers are heterogeneous, with significant variability in morphological and pathological features. These tumors lack the most significant therapeutic markers that guide clinical management of breast cancer: human epidermal growth factor receptor 2 (HER2), estrogen receptoralpha (ER), and progesterone receptor (PR)[1]. TN disease accounts for 12% to 17% of all breast cancers[1,2,3], and epidemiologic studies indicate a higher prevalence of TN tumors among younger women and those of African descent[4,5,6]. Clinicopathologic features of TN breast cancers (TNBCs) include young age at onset, large mean tumor size, high grade and higher incidence of node positivity at presentation compared to what is expected based on tumor size. Patients with TN breast tumors have an increased propensity for lung and brain metastases, making these tumors especially challenging to treat
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