Modern possibilities of drug therapy for early and locally advanced triple negative breast cancer
- Authors: Belokhvostova A.S.1,2, Galitsyna A.B.1,2, Sofiychuk A.A.1, Falaleeva N.A.1,2, Abdulkhalim A.I.3
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Affiliations:
- A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of Russia
- Obninsk Institute for Nuclear Power Engineering – branch of the National Research Nuclear University MEPHI
- RUDN University
- Issue: Vol 6, No 1 (2026)
- Pages: 14-23
- Section: NEW APPROACHES AND SUCCESSES IN TREATMENT OF ONCOLOGICAL PATIENTS AT THE CURRENT STAGE
- Published: 08.04.2026
- URL: https://mdonco.abvpress.ru/jour/article/view/216
- DOI: https://doi.org/10.17650/2782-3202-2026-6-1-14-23
- ID: 216
Cite item
Abstract
Triple negative breast cancer remains the subtype of breast cancer with the highest rates of recurrence and mortality. Research in the field of tumor biology has led to identification of subgroups of patients with specific molecular features, which has led to the development and approval of many new targeted treatments for this disease.
This review considers current options for the treatment of locally advanced forms of breast cancer at the neoadjuvant stage – the use of carboplatin, targeted therapy with vascular endothelial growth factor inhibitors and immunotherapy. It discusses the practical problems and unanswered questions that arise in connection with the approval of neoadjuvant immunotherapy, and describes the approach used in the clinical practice to use various treatment options and the possibility of combining them to achieve the best early and long-term results.
About the authors
A. S. Belokhvostova
A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Healthof Russia; Obninsk Institute for Nuclear Power Engineering – branch of the National Research Nuclear University MEPHI
Email: galitsyna.anastaisha@gmail.com
ORCID iD: 0000-0002-4709-1726
Russian Federation, 4 Koroleva St., Obninsk 249031; 1 Studgorodok,
249039 Obninsk
A. B. Galitsyna
A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Healthof Russia; Obninsk Institute for Nuclear Power Engineering – branch of the National Research Nuclear University MEPHI
Author for correspondence.
Email: galitsyna.anastaisha@gmail.com
ORCID iD: 0009-0009-0188-8420
Russian Federation, 4 Koroleva St., Obninsk 249031; 1 Studgorodok, 249039 Obninsk
A. A. Sofiychuk
A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Healthof Russia
Email: galitsyna.anastaisha@gmail.com
ORCID iD: 0009-0008-0769-1736
Russian Federation, 4 Koroleva St., Obninsk 249031
N. A. Falaleeva
A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Healthof Russia; Obninsk Institute for Nuclear Power Engineering – branch of the National Research Nuclear University MEPHI
Email: galitsyna.anastaisha@gmail.com
ORCID iD: 0000-0002-0023-4216
Russian Federation, 4 Koroleva St., Obninsk 249031; 1 Studgorodok, 249039 Obninsk
A. I.A. Abdulkhalim
RUDN University
Email: galitsyna.anastaisha@gmail.com
ORCID iD: 0009-0002-6631-3862
Russian Federation, 6 Miklukho-Maklaya St., Moscow 117198
References
- Globocan 2020: Cancer today. International Agency for Research on Cancer (IARC), 2020. Available at: https://gco.iarc.fr/today
- State of oncological care in Russia in 2022. Eds.: А.D. Kaprin, V.V. Starinskiy, A.O. Shachzadova. Moscow: MNIOI im. P.A. Gertsena – filial FGBU “NMITS radiologii” Minzdrava Rossii, 2023. 239 p. (In Russ.).
- Denkert C., Liedtke C., Tutt A., von Minckwitz G. Molecular alterations in triple-negative breast cancer-the road to new treatment strategies. Lancet 2017;389(10087):2430–42. doi: 10.1016/S0140-6736(16)32454-0
- André F., Zielinski C.C. Optimal strategies for the treatment of metastatic triple-negative breast cancer with currently approved agents. Ann Oncol 2012;23(Suppl 6):vi46–51. doi: 10.1093/annonc/mds195
- Lehmann B.D., Bauer J.A., Chen X. et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest 2011;121(7):2750–67. doi: 10.1172/JCI45014
- Yang F., Xiao Y., Ding J.H. et al. Ferroptosis heterogeneity in triple-negative breast cancer reveals an innovative immunotherapy combination strategy. Cell Metab 2023;35(1):84–100.e8. doi: 10.1016/j.cmet.2022.09.021
- Lehmann B.D., Pietenpol J.A. Identification and use of biomarkers in treatment strategies for triple-negative breast cancer subtypes. J Pathol 2014;232(2):142–50. doi: 10.1002/path.4280
- Gibson G.R., Qian D., Ku J.K., Lai L.L. Metaplastic breast cancer: clinical features and outcomes. Am Surg 2005;71(9):725–30. PMID: 16468506
- Bertucci F., Finetti P., Cervera N. et al. Gene expression profiling shows medullary breast cancer is a subgroup of basal breast cancers. Cancer Res 2006;66(9):4636–44. doi: 10.1158/0008-5472.CAN-06-0031
- Hayes M.J., Thomas D., Emmons A. et al. Genetic changes of Wnt pathway genes are common events in metaplastic carcinomas of the breast. Clin Cancer Res 2008;14(13):4038–44. doi: 10.1158/1078-0432.CCR-07-4379
- Von Minckwitz G., Schneeweiss A., Loibl S. et al. Neoadjuvant carboplatin in patients with triple-negative and HER2-positive early breast cancer (GeparSixto; GBG 66): a randomised phase 2 trial. Lancet Oncol 2014;15(7):747–56. doi: 10.1016/S1470-2045(14)70160-3
- Sikov W.M., Berry D.A., Perou C.M. et al. Impact of the addition of carboplatin and/or bevacizumab to neoadjuvant once-per-week paclitaxel followed by dose-dense doxorubicin and cyclophosphamide on pathologic complete response rates in stage II to III triple-negative breast cancer: CALGB 40603 (Alliance). J Clin Oncol 2015;33(1):13–21. doi: 10.1200/JCO.2014.57.0572
- Shepherd J.H., Ballman K., Polley M.C. et al. CALGB 40603 (Alliance): long-term outcomes and genomic correlates of response and survival after neoadjuvant chemotherapy with or without carboplatin and bevacizumab in triple-negative breast cancer. J Clin Oncol 2022;40(12):1323–34. doi: 10.1200/JCO.21.01506
- Geyer C.E., Sikov W.M., Huober J. et al. Long-term efficacy and safety of addition of carboplatin with or without veliparib to standard neoadjuvant chemotherapy in triple-negative breast cancer: 4-year follow-up data from BrighTNess, a randomized phase III trial. Ann Oncol 2022;33(4):384–94. doi: 10.1016/j.annonc.2022.01.009
- Loibl S., OʼShaughnessy J., Untch M. et al. Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial. Lancet Oncol 2018;19(4):497–509. doi: 10.1016/S1470-2045(18)30111-6
- Gray R., Bhattacharya S., Bowden C. et al. Independent review of E2100: a phase III trial of bevacizumab plus paclitaxel versus paclitaxel in women with metastatic breast cancer. J Clin Oncol 2009;27(30):4966–72. doi: 10.1200/JCO.2008.21.6630
- Earl H.M., Hiller L., Dunn J.A. et al. Efficacy of neoadjuvant bevacizumab added to docetaxel followed by fluorouracil, epirubicin, and cyclophosphamide, for women with HER2-negative early breast cancer (ARTemis): an open-label, randomised, phase 3 trial. Lancet Oncol 2015;16(6):656–66. doi: 10.1016/S1470-2045(15)70137-3
- Nahleh Z.A., Barlow W.E., Hayes et al. SWOG S0800 (NCI CDR0000636131): addition of bevacizumab to neoadjuvant nab-paclitaxel with dose-dense doxorubicin and cyclophosphamide improves pathologic complete response (pCR) rates in inflammatory or locally advanced breast cancer. Breast Cancer Res Treat 2016;158(3):485–95. doi: 10.1007/s10549-016-3889-6
- Guarneri V., Dieci M.V., Bisagni G. et al. Preoperative carboplatin-paclitaxel-bevacizumab in triple-negative breast cancer: final results of the phase II Ca.Pa.Be study. Ann Surg Oncol 2015;22(9):2881–7. doi: 10.1245/s10434-015-4371-0
- Kimbung S., Markholm I., Bjöhle J. et al. Assessment of early response biomarkers in relation to long-term survival in patients with HER2-negative breast cancer receiving neoadjuvant chemotherapy plus bevacizumab: results from the Phase II PROMIX trial. Int J Cancer 2018;142(3):618–28. doi: 10.1002/ijc.31070
- Loibl S., Untch M., Burchardi N. et al. A randomised phase II study investigating durvalumab in addition to an anthracycline taxane-based neoadjuvant therapy in early triple-negative breast cancer: clinical results and biomarker analysis of GeparNuevo study. Ann Oncol 2019;30(8):1279–88. doi: 10.1093/annonc/mdz158
- Loibl S., Schneeweiss A., Huober J. et al. Neoadjuvant durvalumab improves survival in early triple-negative breast cancer independent of pathological complete response. Ann Oncol 2022;33(11):1149–58. doi: 10.1016/j.annonc.2022.07.1940
- Schmid P., Cortes J., Pusztai L. et al. KEYNOTE-522 Investigators. Pembrolizumab for early triple-negative breast cancer. N Engl J Med 2020;382(9):810–21. doi: 10.1056/NEJMoa1910549
- Nanda R., Liu M.C., Yau C. et al. Effect of pembrolizumab plus neoadjuvant chemotherapy on pathologic complete response in women with early-stage breast cancer: an analysis of the ongoing phase 2 adaptively randomized I-SPY2 trial. JAMA Oncol 2020;6(5):676–84. doi: 10.1001/jamaoncol.2019.6650
- Mittendorf E.A., Zhang H., Barrios C.H. et al. Neoadjuvant atezolizumab in combination with sequential nab-paclitaxel and anthracycline-based chemotherapy versus placebo and chemotherapy in patients with early-stage triple-negative breast cancer (IMpassion031): a randomised, double-blind, phase 3 trial. Lancet 2020;396(10257):1090–100. doi: 10.1016/S0140–6736(20)31953-X
- Gianni L., Huang C.S., Egle D. et al. Pathologic complete response (pCR) to neoadjuvant treatment with or without atezolizumab in triple-negative, early high-risk and locally advanced breast cancer: NeoTRIP Michelangelo randomized study. Ann Oncol 2022;33(5):534–43. doi: 10.1016/j.annonc.2022.02.004
- Pusztai L., Yau C., Wolf D.M. et al. Durvalumab with olaparib and paclitaxel for high-risk HER2-negative stage II/III breast cancer: results from the adaptively randomized I-SPY2 trial. Cancer Cell 2021;39(7):989–98.e5. doi: 10.1016/j.ccell.2021.05.009
- Eikesdal H.P., Yndestad S., Elzawahry A. et al. Olaparib monotherapy as primary treatment in unselected triple negative breast cancer. Ann Oncol 2021;32(2):240–9. doi: 10.1016/j.annonc.2020.11.009
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