Triple-negative breast cancer: are we making headway at least?

M Arnedos, C Bihan, S Delaloge… - … advances in medical …, 2012 - journals.sagepub.com
M Arnedos, C Bihan, S Delaloge, F Andre
Therapeutic advances in medical oncology, 2012journals.sagepub.com
The so-called triple-negative breast cancer, as defined by tumors that lack estrogen
receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2)
overexpression, has generated growing interest in recent years despite representing less
than 20% of all breast cancers. These tumors constitute an important clinical challenge, as
they do not respond to endocrine treatment and other targeted therapies. As a group they
harbor an aggressive clinical phenotype with early development of visceral metastases and …
The so-called triple-negative breast cancer, as defined by tumors that lack estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2) overexpression, has generated growing interest in recent years despite representing less than 20% of all breast cancers. These tumors constitute an important clinical challenge, as they do not respond to endocrine treatment and other targeted therapies. As a group they harbor an aggressive clinical phenotype with early development of visceral metastases and a poor long-term prognosis. While chemotherapy remains effective in triple-negative disease, research continues to further identify potential new targets based on phenotypical and molecular characteristics of these tumors. In this respect, the presence of a higher expression of different biomarkers including epidermal growth factor receptor, vascular endothelial growth factor receptor, fibroblast growth factor receptor and Akt activation has led to a proliferation of clinical trials assessing the role of inhibitors to these pathways in triple-negative tumors. Moreover, the described overlap between triple-negative and basal-like tumors, and the similarities with tumors arising in the BRCA1 mutation carriers has offered potential therapeutic avenues for patients with these cancers including poly (ADP-ribose) polymerase inhibitors and a focus on a higher sensitivity to alkylating chemotherapy agents. Results from these trials have shown some benefit in small subgroups of patients, even in single-agent therapy, which reflects the heterogeneity of triple-negative breast cancer and highlights the need for a further subclassification of these types of tumors for better prognosis identification and treatment individualization.
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