Triple negative breast cancer

04/2021

MUDr. Michaela Miškovičová, Ph.D.

Onkologická klinika 1. LF a VFN, Praha

SUMMARY

Triple negative breast cancer (TNBC) represents a heterogeneous group of breast cancers, histologically, molecularly biologically and immunologically. A common molecular feature is that they do not express alpha estrogen, progesterone, and HER2 receptors.¹ They appear to be the most aggressive subtype of breast cancer and are usually associated with a serious prognosis and increased mortality worldwide. Their extremely high proliferation and tendency to hematogenous metastasis are typical.² The severity of this disease is primarily observed in younger women but can occur in all age groups. Epidemiologically, they represent about 15-20 % of newly diagnosed breast cancers.³ Young patients often suffer from worse clinical outcomes, such as early relapse and the appearance of visceral metastases. Current clinical treatment of TNBC is generally challenging, with chemoresistance and recurrent tumor recurrence being common barriers.⁴

We have seen little therapeutic progress in recent decades, and chemotherapy remains the standard of care. Although the incorporation of targeting agents such as poly (ADP ribose polymerase (PARP) inhibitors and immune checkpoint inhibitors in clinical practice appears promising, TNBC responses to these therapies still vary widely. However, despite enriched chemosensitivity and immunogenicity, most patients with TNBC do not achieve satisfactory clinical responses. The lack of specific effective therapeutic targets is one of the key factors preventing a significant improvement in the effect of targeted treatment.⁵ Incorporating immunomolecular targets into combination and improving standard chemotherapy, especially in the early stages of the disease, may be key to unlocking the promising future of management of TNBC.⁴

Key words

breast cancer, triple negative, chemoresistance, recurrence, immunotherapy