Evolving Evidence for the Optimization of Neoadjuvant Therapy in Triple-Negative Breast Cancer

Abstract

Representing 15% to 20% of all invasive breast cancers, adjuvant systemic treatment for early-stage, high-risk triple-negative breast cancer (TNBC) is preferentially done in the neoadjuvant setting based on a chemotherapy backbone of anthracyclines and taxanes. Pathological complete response to neoadjuvant treatment constitutes the main objective, regarding its correlation with oncological outcomes. The optimal neoadjuvant regimen to achieve the highest rates of pathological complete response is still under investigation, with the increasing knowledge on the molecular pathways, genomic sequencing, and immunological profile of TNBC allowing for the development of a wide array of new therapeutic options. This review aims to summarize the current evidence and ongoing clinical trials of new therapeutic options for the neoadjuvant treatment of TNBC patients.

Inter-Relationship of Ki-67 and Triple-Negative Breast Cancer

“…Both sporadic basal-like tumors and tumors with BRCA 1 mutations express basal keratins, and both groups cluster together in gene expression profiling [9]. Germline mutations for BRCA genes occur in 10-20% of TNBC patients, and somatic mutations are seen in 3-5% [10]. Apart from somatic mutation in BRCA1 gene: [5,6] 1.…”

“…4.Epidermal growth factor receptor (EGFR): EGFR is expressed in 45-70% of TNBC and is associated with poor prognosis [10]. EGFR inhibitors are being evaluated in metastatic settings with not-so-promising results [18].…”