Directed therapy of subtypes of triple-negative breast cancer.
In developed countries, there has been a remarkable improvement in mortality from breast cancer, but almost all of that benefit has occurred in the estrogen receptor (ER)(+) and human epidermal growth factor receptor (HER)-2(+) subsets. Triple-negative breast cancer, defined as tumors that are negative for ER, progesterone receptor, and HER-2, represent a minority of breast cancers. However, because of the poor prognosis in this particular subtype, triple-negative disease accounts for a disproportionate number of metastatic cases and breast cancer deaths. While chemotherapy is effective in triple-negative disease, research continues to better target therapies and predict prognosis. Recent studies have suggested a link between BRCA mutations and triple-negative disease, but the nature of this link remains opaque. Antiangiogenic agents such as bevacizumab have demonstrated efficacy across subtypes. More recently, poly(ADP-ribose) polymerase inhibitors appear to take advantage of the concept of synthetic lethality, or dual pathway inhibition, in attacking triple-negative and BRCA-associated tumors. These and other studies in triple-negative disease will help us to better identify effective treatment options and improve outcomes in these patients. This article addresses the nature of, and therapeutic strategies for, triple-negative breast cancer.
University of North Carolina, Chapel Hill, North Carolina 27599-7305, USA. lisa_carey@med.unc.edu
Lisa A
LA
Carey
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001549:Benzamides / Q000627:therapeutic use; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D004249:DNA Damage; D066246:ErbB Receptors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D011065:Poly(ADP-ribose) Polymerases / Q000378:metabolism; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism / Q000627:therapeutic use; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001549:Benzamides; D000068258:Bevacizumab; D066246:ErbB Receptors; D011065:Poly(ADP-ribose) Polymerases; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D040262:Receptors, Vascular Endothelial Growth Factor; C090712:iniparib