Neoadjuvant Treatment for Triple Negative Breast Cancer: Recent Progresses and Challenges

Area of Science:

• Oncology
• Medical Research

Background:

• Triple-negative breast cancer (TNBC) is aggressive with limited targeted therapies.
• Tumor heterogeneity in TNBC necessitates subtype-specific treatment strategies.
• Neoadjuvant chemotherapy is standard, but optimal regimens and novel approaches are under investigation.

Purpose of the Study:

• To review recent advancements in neoadjuvant therapies for TNBC.
• To explore the efficacy of various targeted agents and biomarkers.
• To highlight progress in predicting treatment outcomes.

Main Methods:

• Review of current literature on neoadjuvant treatments for TNBC.
• Analysis of studies involving platinum-based chemotherapy, immune checkpoint inhibitors (ICIs), PARP inhibitors (PARPi), and PI3K-AKT-mTOR pathway inhibitors.
• Examination of biomarkers associated with complete pathologic response (pCR).

Main Results:

• Carboplatin addition to ACT regimens improves pCR.
• ICI combinations significantly enhance pCR rates in TNBC.
• Tumor-infiltrating lymphocytes (TILs) and DNA repair deficiency (DRD) mutations correlate with increased pCR.
• PARPi and PI3K-AKT-mTOR pathway inhibitors are under evaluation.
• Novel tumor microenvironment (TME) targeted therapies are emerging.

Conclusions:

• Neoadjuvant treatment for TNBC is evolving with promising targeted therapies.
• Biomarkers like TILs and DRD are crucial for predicting pCR.
• Further research into novel agents and TME-targeted therapies is warranted.