Controversial issues in the neoadjuvant treatment of triple-negative breast cancer.
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Embargo End Date
ICR Authors
Authors
Fitzpatrick, A
Tutt, A
Tutt, A
Document Type
Journal Article
Date
2019-10-01
Date Accepted
2019-09-09
Abstract
Triple-negative breast cancer (TNBC), as a collective group of heterogenous tumours, displays the highest rate of distant recurrence and lowest survival from metastatic disease across breast cancer subtypes. However, a subset of TNBC display impressive primary tumour response to neoadjuvant chemotherapy, translating to reduction in future relapse and increased overall survival. Maximizing early treatment response is crucial to improving the outlook in this subtype. Numerous systemic therapy strategies are being assessed in the neoadjuvant setting and the current paradigm of generic chemotherapy components in regimens for high-risk breast cancers, regardless of biological subtype, is changing. Therapeutic approaches with evidence of benefit include platinum drugs, polyadenosine diphosphate ribose polymerase (PARP) inhibitors, immunotherapy and second adjuvant therapy for those not achieving pathological complete response. Importantly, molecular testing can identify subgroups within TNBC, such as deoxyribonucleic acid (DNA) homologous recombination repair deficiency, lymphocyte-predominant tumours, and TNBC type 4 molecular subtypes. Clinical trials that address the interaction between these biomarkers and treatment approaches are a priority, to identify subgroups benefiting from additional therapy.
Citation
Therapeutic advances in medical oncology, 2019, 11 pp. 1758835919882581 - ?
Source Title
Publisher
SAGE PUBLICATIONS LTD
ISSN
1758-8340
eISSN
1758-8359
Collections
Research Team
Molecular Cell Biology