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Studying Triple Negative Breast Cancer Using Orthotopic Breast Cancer Model
Published on: March 20, 2020
Targeted Treatment of Metastatic Triple-Negative Breast Cancer: A Systematic Review
Anna Martha Hammershøi Madsen1, Rikke Helene Løvendahl Eefsen1, Dorte Nielsen1
1Department of Oncology 54 B1 Herlev Hospital University of Copenhagen, Herlev Ringvej 75, DK-2730, Copenhagen, Denmark.
Introduction:
Triple-negative breast cancer (TNBC) is a subgroup of breast cancer characterized by the absence of estrogen and the human epidermal 2 receptor and also a lack of targeted therapy options. Chemotherapy has so far been the only approved treatment option, and patients with metastatic cancer have a dismal prognosis with a median overall survival (OS) of approximately 14 months. Identification of druggable targets for metastatic TNBC is therefore of special interest.
Methods:
A systematic search was performed, to review the existing evidence on targeted therapies in metastatic TNBC.
Results:
A total of 37 phase 2/3 studies were identified, evaluating 29 different targeted agents. In this review, results on progression free survival (PFS) and OS are presented.
Conclusion:
In most of the studies included, no improvement was observed for neither PFS nor OS; however, a few studies did show improvement with targeted agents and have led to new treatment options in subgroups of patients. The antibody drug conjugate, sacituzumab govitecan, demonstrated superior PFS and OS in comparison to chemotherapy. Immunotherapy with checkpoint inhibitors such as atezolizumab and pembrolizumab is now recommended as a first-line treatment option for patients with expression a PD-L1 positive tumor. Finally, the poly adenosine diphosphate-ribose polymerase (PARP) inhibitors talazoparib and olaparib are recommended, as first-line treatment options in patients with metastatic breast cancer and a germline BRCA mutation, but an immune checkpoint inhibitor should be considered for the subset of these patients who are PD-L1 positive.
Insights
Targeted therapies show promise for triple-negative breast cancer (TNBC). Sacituzumab govitecan and PARP inhibitors offer new options, while immunotherapy is recommended for PD-L1 positive tumors.
Area of Science:
- Oncology
- Medical Science
Background:
- Triple-negative breast cancer (TNBC) lacks targeted therapies, with chemotherapy offering limited survival for metastatic disease.
- Identifying new therapeutic targets for metastatic TNBC is crucial due to poor prognosis.
Approach:
- A systematic literature search identified 37 phase 2/3 studies on 29 targeted agents for metastatic TNBC.
- This review analyzes progression-free survival (PFS) and overall survival (OS) data from these studies.
Key Points:
- Most targeted agents did not improve PFS or OS in TNBC.
- Sacituzumab govitecan demonstrated superior PFS and OS compared to chemotherapy.
- Immunotherapy (atezolizumab, pembrolizumab) is a first-line option for PD-L1 positive tumors.
- PARP inhibitors (talazoparib, olaparib) are recommended for metastatic breast cancer with germline BRCA mutations.
Conclusions:
- Targeted therapies are emerging as valuable treatment options for specific subgroups of metastatic TNBC patients.
- Combination strategies, including immunotherapy for PD-L1 positive subsets, are being explored.
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