Triple negative breast cancer – Understanding the clinical implications of heterogeneity
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Triple negative breast cancers (TNBC) have long been associated with a worse prognosis in contrast to hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER2) positive breast tumours. However, advances in the classification and molecular categorization of TNBC have led to meaningful advances, highlighting substantial TNBC heterogeneity and distinct histomolecular subtypes. While TNBC has historically been treated with single or combined chemotherapeutic agents, novel targeted therapies are being developed and evaluated. A better understanding of oncogenic drivers and the pathogenicity of germline and somatic mutations has also paved the way to new targeted treatments. More recently, the neoadjuvant space has become increasingly popular to better understand the behaviour of TNBC subtypes, leading to the development of biomarker-driven trials to better select targeted treatments. This has ultimately led to a number of advances and new potential targets for treatment which remain under investigation and will undoubtedly lead to a better understanding and personalized approach for patients diagnosed with TNBC.
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