Neoadjuvant treatments in triple-negative breast cancer patients: where we are now and where we are going

Abstract

Triple-negative breast cancer (TNBC) remains the poorest-prognosis breast cancer (BC) subtype. Gene expression profiling has identified at least six different triple-negative subtypes with different biology and sensitivity to therapies. The heterogeneous nature of TN tumors may justify the difficulty in treating this BC subtype. Several targeted agents have been investigated in clinical trials without demonstrating a clear survival benefit. Therefore, systemic chemotherapy remains the cornerstone of current clinical practice. Improving the knowledge of tumor biology is mandatory for patient management. In stages II and III, neoadjuvant systemic treatment is an effective option of care. The achievement of a pathological complete response represents an optimal surrogate for survival outcome as well as a test for tumor drug sensitivity. In this review, we provide a brief description of the main predictive biomarkers for tumor response to systemic treatment. Moreover, we review the treatment strategies investigated for TNBCs in neoadjuvant settings focusing on experimental drugs such as immunotherapy and poly [ADP-ribose] polymerase inhibitors that hold promise in the treatment of this aggressive disease. Therefore, the management of TNBC represents an urgent, current, unmet need in daily clinical practice. A key recommendation is to design biology-driven clinical trials wherein TNBC patients may be treated on the basis of tumor molecular profile.

Knockdown of endothelin receptor B inhibits the progression of triple‐negative breast cancer

“…TNBC is an aggressive malignancy and is prone to recurrence and metastasis . In this study, we found that EDNRB silencing caused the differential expression of 248 proteins, and these proteins belong to different functional categories that are found in cellular organelles and are involved in BPs such as signal transduction.…”

“…Therapeutic approaches such as surgical resection, hormone therapies, target‐specific immunotherapies, radiotherapies, and chemotherapies, together with regular screening and early diagnosis, have significantly improved the survival of most breast cancer patients . However, tumor recurrence, metastasis, and drug resistance are still threats for patients with breast cancer, particularly for those with basal‐like triple‐negative breast cancer (TNBC) because TNBC is insensitive to most available therapies . Currently, the pathogenesis of TNBC is incompletely understood and there is little information on reliable therapeutic targets for treatment of TNBC in the clinic.…”

Efficacy of Neoadjuvant Versus Adjuvant Chemotherapy in Hispanic/Latino (H/L) Women With Local or Locally Advanced Triple-negative Breast Cancer (TNBC)

“…The second advantage is that NACT can eradicate tumor cells from axillary lymph nodes, which helps downstage the cancer and avoid the morbid procedure of axillary lymph node dissection. The third benefit is that it provides an important in vivo observation of the chemosensitivity of the tumor (21).…”

Knockdown of ZEB1 suppressed the formation of vasculogenic mimicry and epithelial-mesenchymal transition in the human breast cancer cell line MDA-MB-231

“…Breast cancer is a common malignant tumor in women and its incidence increases every year; it has therefore become a serious threat to women's health (1,2). In recent years, there has been marked progress in the diagnosis and treatment of breast cancer; however, patient mortality has not been significantly improved (3,4). Currently, Triple Negative Breast Cancer (TNBC) with all negative estrogen receptor/progesterone receptor/human epidermal growth factor receptor-2 has become a growing concern for clinicians (5).…”