Onkológia 3/2024

Therapeutic procedures in the treatment of advanced triple-negative breast cancer – a nationwide survey among selected oncologists from oncology institutes and regional cancer centers in Slovakia

Triple negative breast cancer (TNBC) is characterized by the lack of estrogen and progesterone receptor expression and lacks HER2 overexpression or gene amplification. It accounts approximately for 10–15% of incident breast cancers and carries the worst prognosis. Like other breast cancers, TNBC is biologically heterogeneous, leading to diverse clinical behavior and different prognosis, however, unlike the other clinical subtypes, in TNBC we still lack tumor-specific targeted therapy. Tumor targeting advances include improvements in the application of cytotoxic drug, along with antibody-drug conjugates such as sacituzumab govitecan, which has been approved for treatment of patients with advanced TNBC and patients with advanced hormon positive/HER2 negative breast cancer and trastuzumab deruxtecan, which has shown benefit in patients with HER2-low disease in addition to HER2-positive breast cancer. For those with BRCA1/2 genes mutation, PARP inhibitors are being investigated as a truly tumor-targeted drug. Immunotherapy has also made an impact, with chemotherapy plus immune checkpoint inhibitor therapy being used in regardless of PD-L1 status in early disease. It is also a preferred frontline therapy for metastatic TNBC in those with high PD-L1 expression. The improvements in targeted therapy and immunotherapy are critical for patients as researchers continue to investigate more tailored therapies.

Keywords: triple negative breast cancer, molecular subtypes of TNBC, early TNBC, advanced TNBC, chemotherapy, immunotherapy, PARP inhibitors, conjugates, survey, ESMO guidelines