Precision Breast Cancer Medicine: early stage triple negative breast cancer - a review of molecular characterisation, therapeutic targets and future trends

Abstract

Breast cancer (BC) is the most common cancer affecting women and is the leading cause of cancer related death in women worldwide1. Approximately 15% of all breast cancers are triple negative breast cancers (TNBC)2. This is a highly heterogeneous subtype which behaves aggressively, and relative to other BC subtypes, has a poorer prognosis, higher risk of relapse and shorter overall survival (OS)3. Genomic and transcriptomic data has enhanced our ability to classify and understand TNBC and enabled identification of new therapeutic targets. Despite these advances, very few novel therapies are currently in routine clinical use and TNBC remains a difficult cancer to treat effectively. This review aims to provide an overview of contemporary practice in the treatment of early stage TNBC and to highlight promising future directions. We will discuss the growing evidence for lesser known therapies which may contribute to the forthcoming advances in this field. Finally, we will propose a framework for the personalised management of TNBC based upon the integration of clinical and molecular characteristics to ensure optimal long term outcomes.