title: The fate of chemoresistance in triple negative breast cancer (TNBC).
abstract: BACKGROUND
  Treatment options for women presenting with triple negative breast cancer (TNBC) are limited due to the lack of a therapeutic target and as a result, are managed with standard chemotherapy such as paclitaxel (Taxol®). Following chemotherapy, the ideal tumour response is apoptotic cell death. Post-chemotherapy, cells can maintain viability by undergoing viable cellular responses such as cellular senescence, generating secretomes which can directly enhance the malignant phenotype.
  
  
  METHODS
  How tumour cells retain viability in response to chemotherapeutic engagement is discussed. In addition we discuss the implications of this retained tumour cell viability in the context of the development of recurrent and metastatic TNBC disease. Current adjuvant and neo-adjuvant treatments available and the novel potential therapies that are being researched are also reviewed.
  
  
  CONCLUSIONS
  Cellular senescence and cytoprotective autophagy are potential mechanisms of chemoresistance in TNBC. These two non-apoptotic outcomes in response to chemotherapy are inextricably linked and are neglected outcomes of investigation in the chemotherapeutic arena. Cellular fate assessments may therefore have the potential to predict TNBC patient outcome.
  
  
  CONCLUSIONS
  Focusing on the fact that cancer cells can bypass the desired cellular apoptotic response to chemotherapy through cellular senescence and cytoprotective autophagy will highlight the importance of targeting non-apoptotic survival pathways to enhance chemotherapeutic efficacy.
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland ; Department of Surgery, Mater Misericordiae Hospital, Dublin 7, Ireland.
authors.forename: Elma A
authors.initials: EA
authors.lastname: O'Reilly
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland.
authors.forename: Luke
authors.initials: L
authors.lastname: Gubbins
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland ; Department of Surgery, Mater Misericordiae Hospital, Dublin 7, Ireland.
authors.forename: Shiva
authors.initials: S
authors.lastname: Sharma
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland.
authors.forename: Riona
authors.initials: R
authors.lastname: Tully
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland.
authors.forename: Matthew Ho Zhing
authors.initials: MH
authors.lastname: Guang
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Weiner-Gorzel
authors.affiliation: Department of Oncology, Mater Misericordiae Hospital, Dublin 7, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: McCaffrey
authors.affiliation: Department of Pathology, Mater Misericordiae Hospital, Dublin 7, Ireland.
authors.forename: Michele
authors.initials: M
authors.lastname: Harrison
authors.affiliation: School of Pharmacy, Queens University Belfast, Belfast BT7 1NN, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Furlong
authors.affiliation: Department of Surgery, Mater Misericordiae Hospital, Dublin 7, Ireland.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kell
authors.affiliation: UCD Conway Institute of Biomolecular and Biomedical Research, UCD School of Medicine and Medical Science (SMMS), Belfield, Dublin 4, Ireland.
authors.forename: Amanda
authors.initials: A
authors.lastname: McCann
keywords: Cellular fates; Cellular senescence; Chemoresistance; Hypoxia; Triple negative breast cancer (TNBC)