Targeted Therapies for Triple-Negative Breast Cancer

医学 奥拉帕尼 阿替唑单抗 乳腺癌 三阴性乳腺癌 肿瘤科 内科学 靶向治疗 癌症 艾瑞布林 PARP抑制剂 癌症研究 转移性乳腺癌 免疫疗法 彭布罗利珠单抗 生物 基因 聚ADP核糖聚合酶 生物化学 聚合酶
作者
Tomás G. Lyons
出处
期刊:Current Treatment Options in Oncology [Springer Science+Business Media]
卷期号:20 (11) 被引量:273
标识
DOI:10.1007/s11864-019-0682-x
摘要

Triple-negative breast cancer (TNBC) is a particularly aggressive subtype of breast cancer. TNBC is a heterogenous subtype of breast cancer that is beginning to be refined by its molecular characteristics and clinical response to a targeted therapeutic approach. Until recently the backbone of therapy against TNBC has been cytotoxic chemotherapy. However, the breast oncology community is now seeing encouraging clinical activity from molecularly targeted approaches to TNBC. Recently, we have seen 3 newly approved targeted therapies for TNBC, including the PARP inhibitors olaparib and talazoparib for germline BRCA mutation associated breast cancer (gBRCAm-BC) and most recently the checkpoint inhibitor, atezolizumab in combination with nab-paclitaxel for programmed death-ligand 1 (PD-L1+) advanced TNBC. Improved biomarkers are needed to inform better patient selection for treatment with checkpoint inhibition. Higher response rates are seen when checkpoint inhibitors are combined with chemotherapy in the first-line setting and the use of these agents at an earlier stage of the disease does show promise. Antibody-drug conjugates are generating much excitement and may allow re-examination of prior cytotoxics that failed in development due to toxicity. Tumor sequencing is identifying potential molecular targets and ongoing studies are evaluating novel small molecule agents in this field such as AKT inhibition and many others. The treatment paradigm of chemotherapy as “one size fits all” approach for management of TNBC is changing based on molecular subtyping. Soon, the term TNBC may no longer be appropriate, as this heterogenous subtype of breast cancer is further refined by its molecular characteristics and clinical response to a targeted therapeutic approach.
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