Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
J Clin Oncol. 2012 May 20;30(15):1879-87. doi: 10.1200/JCO.2011.38.2010. Epub 2012 Mar 26.
Triple-negative breast cancer (TNBC) accounts for 15% to 20% of breast cancers. It is a heterogeneous disease, not only on the molecular level, but also on the pathologic and clinical levels. TNBC is associated with a significantly higher probability of relapse and poorer overall survival in the first few years after diagnosis when compared with other breast cancer subtypes. This is observed despite its usual high sensitivity to chemotherapy. In the advanced setting, responses observed with chemotherapy lack durability. Early-stage clinical studies suggested impressive potential when a poly (ADP-ribose) polymerase (PARP) inhibitor is given for the treatment of advanced TNBC with BRCA gene dysfunction. The molecular complexity of TNBC has led to proposed subclassifications, which will be of great value for the development of targeted therapies. In this review, we discuss the biology of TNBC at the pathologic and the molecular levels. We also elaborate on the role of systemic therapies and the results of the first phase III clinical trial evaluating the addition of iniparib, a novel investigational anticancer agent that does not possess characteristics typical of the PARP inhibitor class, in combination with chemotherapy in advanced TNBC.
三阴性乳腺癌（TNBC）占乳腺癌的 15%至 20%。它是一种异质性疾病，不仅在分子水平上，而且在病理和临床水平上也是如此。与其他乳腺癌亚型相比，TNBC在诊断后最初几年复发的可能性明显更高，总体生存率更差。尽管其通常对化疗高度敏感，但仍存在这种情况。在晚期，化疗观察到的反应缺乏持久性。早期临床研究表明，当使用聚（ADP-核糖）聚合酶（PARP）抑制剂治疗 BRCA 基因功能障碍的晚期 TNBC 时，具有令人印象深刻的潜在作用。TNBC 的分子复杂性导致了提出的亚分类，这对于开发靶向治疗将具有重要价值。在这篇综述中，我们讨论了 TNBC 在病理和分子水平上的生物学特性。我们还详细阐述了系统治疗的作用以及评估新型研究性抗癌药物 iniparib（不具有 PARP 抑制剂类典型特征的药物）联合化疗治疗晚期 TNBC 的首次 III 期临床试验结果。
