title: Neoadjuvant Therapy for Patients with Triple Negative Breast Cancer (TNBC).
abstract: Patients with triple negative breast cancer (TNBC) are characterized by an unfavorable prognosis particularly when not responding well to anthracycline-taxane chemotherapy. This is due to a more aggressive biology in some cases but most importantly to a lack of agents other than conventional chemotherapy. Hence, there is an urgent need to optimize therapy of patients with TNBC in order to improve prognosis.
  
  
  
  The objective of this review is to present the current understanding of TNBC biology and give an insight of current therapeutic concepts in the neoadjuvant treatment setting.
  
  
  
  Current literature has been selected based on a literature search and current therapeutic concepts are explained and commented on.
  
  
  
  Novel therapeutic concepts for patients with TNBC focus on a) chemotherapy optimization through alternate scheduling, dosing or alternative/additional chemotherapeutic agents, b) evaluation of novel targeted agents and c) identification of clinically relevant patient subgroups through prognostic/ predictive biomarkers to enable a more personalized treatment approach. Potential novel therapeutic targets include inhibition of Poly-A-Ribose-Polymerase (PARP), checkpoint inhibition and antiandrogenic agents.
  
  
  
  Treatment of TNBC is currently been optimized both through optimization of chemotherapy and introduction of novel targeted agents which should enhance treatment response rates in the future.
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Liedtke
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Rody
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000187:drug effects*; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases
keywords: BRCA1/2; checkpoint inhibition; chemotherapy PARP inhibition; platinum-salts; triple negative breast cancer