Abstract
Abstract Triple-negative breast cancer is a particularly difficult to treat and biologically aggressive disease with limited treatment options. However, a subset of patients with triple-negative tumours may respond to chemotherapy. Therefore, optimisation of chemotherapy regimens may be key in treating triple-negative breast cancer. Emerging treatment approaches include novel chemotherapeutic agents such as the epothilones. The epothilones are a group of novel microtubule-stabilising agents with demonstrated activity in anthracycline-/taxane-resistant triple-negative breast cancer, and ongoing trials are evaluating the combination of epothilones with targeted agents or inclusion of epothilones in novel combination regimens. Other interesting new treatment options include the PARP inhibitors, which are currently in clinical trials for triple-negative breast cancer.
Highlights
Hormone receptor and human epidermal growth factor receptor 2 (HER2) status identify key molecular subtypes of human breast tumours and currently guide choice of therapy.For patients with hormone-receptor positive metastatic breast cancer (MBC), hormone therapy with tamoxifen, fulvestrant, and aromatase inhibitors or ovarian suppression represent the backbone of treatment, with or without additional chemotherapy
Triple-negative disease is characterised by a high proliferation rate, high risk of early recurrence and a high incidence of visceral and CNS metastases. 2,3 For this aggressive subset of breast cancer, effective treatment choices are currently limited to chemotherapy; no targeted agents have been developed for triple-negative cancer
Clinical trials of bevacizumab in combination with either paclitaxel or docetaxel as first-line therapy for patients with metastatic or locally advanced breast cancer demonstrated that combination treatment significantly increased both the objective response rate and the median progression-free survival (PFS) compared with monotherapy. 24,25 Miller and coworkers (2007) reported a significant improvement in the overall response rate with paclitaxel plus bevacizumab as first-line therapy for MBC (36.9% vs 21.2% for paclitaxel alone; P = 0.0001)
Summary
Hormone receptor (oestrogen and progesterone) and human epidermal growth factor receptor 2 (HER2) status identify key molecular subtypes of human breast tumours and currently guide choice of therapy. 2,3 For this aggressive subset of breast cancer, effective treatment choices are currently limited to chemotherapy; no targeted agents have been developed for triple-negative cancer. It is important to note that the prognosis for triple-negative patients who achieve a pCR with chemotherapy in the neoadjuvant setting is similar to that for other breast cancer phenotypes. Due to the high risk of relapse and lack of other therapeutic options, the majority of triple-negative breast cancer patients receive adjuvant chemotherapy. A number of new treatment options have emerged for patients with triple-negative disease These include a novel group of cytotoxic agents, the epothilones, as well as agents with molecular targets. This article reviews the latest developments for treating patients with triplenegative breast cancer
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