Putting It All Together: Clinical Pearls of Recently Approved Therapies for Triple-Negative Breast Cancer

Three recently approved therapies for the treatment of triple-negative breast cancer (TNBC), including poly(ADP-ribose) polymerase (PARP) inhibitors, immunotherapy, and antibody-drug conjugates (ADC) have changed the management of several patients with advanced, metastatic, and even early-stage TNBC. PARP inhibitors, such as olaparib and talazoparib, have been approved as therapies for BRCA-mutated human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (BC). Immunotherapy has been approved for patients with programmed death ligand 1 (PD-L1)-positive, metastatic TNBC. Immune checkpoint inhibitors (ICIs), such as atezolizumab and pembrolizumab demonstrated a significant improvement in progression-free survival (PFS) (in combination with chemotherapy). An antibody-drug conjugate (ADC), sacituzumab govitecan (SG) (that targets trophoblast cell surface antigen 2 (Trop-2)), has shown efficacy and prolonged PFS and overall survival (OS) in patients with metastatic TNBC. The goal of this chapter is to briefly review some of the most promising therapies available for the treatment of TNBC, including PARP inhibitors, ICIs, and ADCs. Considerations of choosing these therapeutic options and their sequence, in the context of the BRCA mutation and the PD-L1 positivity, in patients with TNBC have been discussed.

Keywords: Atezolizumab, Antibody drug conjugates (ADCs), Human epidermal growth factor receptor 2 (HER2), Immune checkpoint inhibitors (ICIs), Olaparib, Poly (ADP-ribose) polymerase (PARP) inhibitors, Pembrolizumab, Programmed death ligand 1 (PD-L1), Sacituzumab govitecan, Talazoparib, Triple-negative breast cancer (TNBC).