Triple Negative Breast Cancer Treatment Options and Limitations: Future Outlook

Abstract

Triple negative breast cancer (TNBC) has a negative expression of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptors (HER2). The survival rate for TNBC is generally worse than other breast cancer subtypes. TNBC treatment has made significant advances, but certain limitations remain. Treatment for TNBC can be challenging since the disease has various molecular subtypes. A variety of treatment options are available, such as chemotherapy, immunotherapy, radiotherapy, and surgery. Chemotherapy is the most common of these options. TNBC is generally treated with systemic chemotherapy using drugs such as anthracyclines and taxanes in neoadjuvant or adjuvant settings. Developing resistance to anticancer drugs and off-target toxicity are the primary hindrances to chemotherapeutic solutions for cancer. It is imperative that researchers, clinicians, and pharmaceutical companies work together to develop effective treatment options for TNBC. Several studies have suggested nanotechnology as a potential solution to the problem of suboptimal TNBC treatment. In this review, we summarized possible treatment options for TNBC, including chemotherapy, immunotherapy, targeted therapy, combination therapy, and nanoparticle-based therapy, and some solutions for the treatment of TNBC in the future. Moreover, we gave general information about TNBC in terms of its characteristics and aggressiveness.

Keywords: chemotherapy; immunotherapy; limitations; nanotechnology; triple negative breast cancer.

Figure 1

Metastasized TNBC. Many distinct characteristics are associated with TNBC. These characteristics include a high level of cell invasiveness and metastasis to other organs, such as the brain, the lungs, or the liver [10]. Created with Biorender.Com, accessed on 14 June 2023.

Figure 2

Subtypes of TNBC with their characteristic pathways. On the basis of gene expression profiles, six TNBC subtypes have been classified, each with a specific gene expression profile and ontology [28]. Created with Biorender.com, accessed on 15 June 2023.

Figure 3

Various triple negative breast cancer (TNBC) treatments available in the clinic. As far as therapeutic strategies are concerned, several approaches have been proposed for both patients with early and advanced triple negative breast cancer (TNBC). These include immunotherapy, deoxyribonucleic acid (DNA)-interfering agents, and targeted therapies [53]. Created with Biorender.com, accessed on 14 June 2023.

Figure 4

Targeting TNBC with passive and active strategies based on nanotechnology. Passive targeting relies on rapid vascularization growth and poor lymphatic drainage to increase permeability and retention (EPR). As a result, nanoparticles are retained in tumors. An active targeting strategy involves the interaction of nanoparticle surface ligands with cell surface receptors [147]. Created with Biorender.com, accessed on 16 June 2023.