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Updated: May 9, 2026
Studying Triple Negative Breast Cancer Using Orthotopic Breast Cancer Model
Published on: March 20, 2020
Relapsed triple-negative breast cancer: challenges and treatment strategies
Valentina Guarneri1, Maria Vittoria Dieci, Pierfranco Conte
1Medical Oncology 2, Istituto Oncologico Veneto IRCCS, University of Padova, Via Gattamelata 64, 35128 Padua, Italy.
Abstract:
Triple negative breast cancer (TNBC) is the most lethal form of breast cancer. Treatment options for advanced disease are limited, with a median survival from the time of developing metastases rarely exceeding 1 year. TNBC is heterogeneous, and harbours several molecular alterations. Unfortunately, up to now, clinical trials combining targeted agents and chemotherapy have failed to show substantial survival improvement; therefore, chemotherapy remains the backbone of treatment. No major advances have been made in the field of cytotoxic treatments, and hopefully ongoing trials will contribute to a more precise definition of the role of platinum salts in sporadic and BRCA-mutated TNBC. Moreover, recent gene expression data suggest that TNBC can be further segmented into smaller subgroups, characterized by different activated pathways, which may therefore warrant different targeted treatments. The lack of efficacy that has been observed for the majority of targeted agents in TNBC so far may derive from the inclusion of unselected TNBC patient populations, not enriched for patients presenting an alteration in the target. Therefore, one of the major challenges in the future is to integrate biological data into clinical trials to obtain the highest efficacy from promising targeted treatments such as anti-angiogenetic agents, poly (ADP-ribose) polymerase-1 (PARP), epidermal growth factor receptor, fibroblast growth factor receptor, androgen receptor and phosphoinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) inhibitors.
Insights
Triple negative breast cancer (TNBC) is aggressive with limited treatment options. Future research must integrate biological data for targeted therapies to improve survival in TNBC patients.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Triple negative breast cancer (TNBC) is the most lethal breast cancer subtype.
- Advanced TNBC has limited treatment options and poor prognosis, with median survival rarely exceeding one year post-metastasis.
- Chemotherapy remains the primary treatment, as clinical trials combining targeted agents with chemotherapy have not significantly improved survival.
Purpose of the Study:
- To review the current treatment landscape for advanced triple negative breast cancer.
- To highlight the heterogeneity of TNBC and the need for personalized treatment strategies.
- To discuss the potential of integrating biological data into clinical trials for novel targeted therapies.
Main Methods:
- Review of current literature on TNBC treatment and molecular alterations.
- Analysis of gene expression data suggesting TNBC sub-segmentation.
- Discussion of challenges and future directions in TNBC clinical trials.
Main Results:
- TNBC is molecularly heterogeneous, necessitating tailored treatment approaches.
- Previous clinical trials combining targeted agents and chemotherapy have shown limited success, possibly due to unselected patient populations.
- Ongoing trials are investigating the role of platinum salts in sporadic and BRCA-mutated TNBC.
Conclusions:
- Chemotherapy remains the standard of care for TNBC.
- Future TNBC treatment strategies must leverage biological data to identify patient subgroups and guide the use of targeted therapies.
- Promising targeted agents include anti-angiogenetic agents, PARP inhibitors, and inhibitors of EGFR, FGFR, AR, and PI3K/mTOR pathways.
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