Current and emerging biologic therapies for triple negative breast cancer

Introduction Triple negative breast cancer, defined by a lack of estrogen receptor, progesterone receptor, or human epidermal growth factor2, accounts for approximately 15% of breast cancer patients. Treatment options have historically been limited to chemotherapy, which has significant toxicity and a suboptimal impact on the five-year relapse rate and survival. Areas covered Transcriptomic analyses reveal that TNBC is biologically heterogenous. Predictive biomarkers based on the distinct biology of the different subtypes of TNBC should identify patients that will derive the greatest benefit from a specifically targeted therapeutic agent. Two biomarker-driven treatments have recently been approved: poly-ADP ribose polymerase inhibitors for patients with germlineBRCAmutations and atezolizumab in combination withnab-paclitaxel for patients expressing PD-L1 on tumor-infiltrating immune cells. Expert opinion Identifying informative predictive biomarkers is critical for the optimal development of targeted drugs for TNBC. Some targeted agents, such as the antibody-drug conjugate sacituzumab govitecan-hziy and the precision medicines capivasertib and ipatisertib, have already shown promising results in early clinical trials, and the results of definitive phase 3 trials are eagerly awaited. Additionally, testing novel immunotherapies and other targeted agents in earlier stages of disease, particularly the neoadjuvant setting, is a high priority.

Automated summary

Triple negative breast cancer (TNBC), which lacks estrogen receptor, progesterone receptor, or human epidermal growth factor2, accounts for approximately 15% of breast cancer patients. Limited treatment options have historically been available, but recent transcriptomic analyses have revealed the biological heterogeneity of TNBC. Predictive biomarkers based on the distinct biology of TNBC subtypes have been identified to determine which patients will benefit the most from targeted therapies. Two biomarker-driven treatments have been recently approved.