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Review
. 2020 Apr;8(7):499.
doi: 10.21037/atm.2020.03.194.

Molecular subtypes and precision treatment of triple-negative breast cancer

Shen Zhao  1 , Wen-Jia Zuo  1 , Zhi-Ming Shao  1 , Yi-Zhou Jiang  1
Affiliations
Review

Molecular subtypes and precision treatment of triple-negative breast cancer

Shen Zhao et al. Ann Transl Med. 2020 Apr.

Abstract

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype. Despite the progress made in precision treatment of cancer patients, targeted treatment is still at its early stage in TNBC, and chemotherapy remains the standard treatment. With the advances in next generation sequencing technology, genomic and transcriptomic analyses have provided deeper insight into the inter-tumoral heterogeneity of TNBC. Much effort has been made to classify TNBCs into different molecular subtypes according to genetic aberrations and expression signatures and to uncover novel treatment targets. In this review, we summarized the current knowledge regarding the molecular classification of TNBC and explore the future paradigm for using molecular classification to guide the development of precision treatment and clinical practice.

Keywords: Triple-negative breast cancer (TNBC); molecular subtypes; precision treatment.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm.2020.03.194). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Schematic representation of TNBC molecular subtypes. This figure shows the association of the transcriptomic TNBC subtypes with other tumor characteristics. The BLIS subtype is correlated with enrichment of HRD mutation signature and high chromosomal instability. The LAR subtype and MES subtype present high frequency of PI3K pathway mutations. The IM subtype is characterized by high immune infiltration and good prognosis. TNBC, triple-negative breast cancer; HRD, homologous recombination deficiency; HER2, human epidermal growth factor receptor 2.
Figure 2
Figure 2
Transformation of precision medicine patterns for TNBC. This figure shows the evolution of precision treatment paradigm for TNBCs from biomarker-based targeted therapy to subtyping-based targeted therapy. The subtyping-based paradigm provides deeper insight to the molecular essence of patient tumors and contributes to more efficient target identification and drug development. TNBC, triple-negative breast cancer; HRD, homologous recombination deficiency; PD-1, programmed Cell Death 1; PD-1, programmed Cell Death ligand 1; AR, androgen receptor.
See this image and copyright information in PMC

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