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Futuro y líneas de investigación clínica del cáncer de mama triple negativo avanzado

Javier Blanco Ávila, María Olmedo López-Frías, Sandra Rubio Bernabé, Marta Santisteban Eslava

Prepublicado: 2023-07-12
Publicado: 2023-07-12
VOLUMEN 37, NÚM. 1, enero-febrero (2023), PAG. 17-29

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El cáncer de mama triple negativo se caracteriza por una alta tasa de recaídas con respecto al resto de subtipos biológicos y por un peor pronóstico, con una supervivencia que no alcanza los 2 años desde la aparición de las metástasis a distancia. Esto es debido en gran medida a la gran heterogeneidad intratumoral, la ausencia de dianas oncogénicas drogables identificadas y a una mayor agresividad tumoral, que conllevan una alta tasa de resistencias terapéuticas. Con este artículo pretendemos ahondar en la aplicación de nuevas estrategias terapéuticas en estudio (anticuerpos droga conjugados, terapia endocrina antiandrogénica, inhibidores de PARP, inmunoterapia con inhibidores de punto de control inmune y/o con terapia celular) en monoterapia o en diferentes combinaciones para las pacientes con cáncer de mama avanzado triple negativo que puedan impactar en la supervivencia de las pacientes.

Palabras Clave: Cáncer de mama triple negativo. Estadio avanzado. Nuevas terapias.



SEOM. 2022. Las cifras del cáncer en España. Accesed March 15, 2023. Available at (https://seom.org/images/LAS_CIFRAS_DEL_CANCER_EN_ESPANA_2022.pdf
Bou Zerdan M, Ghorayeb T, Saliba F, et al. Triple Negative Breast Cancer: Updates on Classification and Treatment in 2021. Cancers (Basel). 2022;14(5):1253. Published 2022 Feb 28.
DOI: 10.3390/cancers14051253
Grinda T, Antoine A, Jacot W, Blaye C, Cottu PH, Diéras V, Dalenc F, Gonçalves A, Debled M, Patsouris A, Mouret-Reynier MA, Mailliez A, Clatot F, Levy C, Ferrero JM, Desmoulins I, Uwer L, Petit T, Jouannaud C, Lacroix-Triki M, Deluche E, Robain M, Courtinard C, Bachelot T, Brain E, Pérol D, Delaloge S. Evolution of overall survival and receipt of new therapies by subtype among 20 446 metastatic breast cancer patients in the 2008-2017 ESME cohort. ESMO Open. 2021 Jun;6(3):100114.
DOI: 10.1016/j.esmoop.2021.100114
Plichta JK, Thomas SM, Hayes DF, Chavez-MacGregor M, Allison K, de Los Santos J, Fowler AM, Giuliano AE, Sharma P, Smith BD, van Eycken E, Edge SB, Hortobagyi GN. Novel Prognostic Staging System for Patients With De Novo Metastatic Breast Cancer. J Clin Oncol. 2023 Mar 21:JCO2202222.
DOI: 10.1200/JCO.22.02222
Allison KH, Hammond MEH, Dowsett M, McKernin SE, Carey LA, Fitzgibbons PL, Hayes DF, Lakhani SR, Chavez-MacGregor M, Perlmutter J, Perou CM, Regan MM, Rimm DL, Symmans WF, Torlakovic EE, Varella L, Viale G, Weisberg TF, McShane LM, Wolff AC. Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update. J Clin Oncol. 2020 Apr 20;38(12):1346-1366.
DOI: 10.1200/JCO.19.02309
Bareche Y, Buisseret L, Gruosso T, Girard E, Venet D, Dupont F, Desmedt C, Larsimont D, Park M, Rothé F, Stagg J, Sotiriou C. Unraveling Triple-Negative Breast Cancer Tumor Microenvironment Heterogeneity: Towards an Optimized Treatment Approach. J Natl Cancer Inst. 2020 Jul 1;112(7):708-719.
DOI: 10.1093/jnci/djz208
Lehmann BD, Bauer JA, Chen X, Sanders ME, Chakravarthy AB, Shyr Y, Pietenpol JA. Identification of human triple-negative breast cancer subtypes and preclinical models for selection of targeted therapies. J Clin Invest. 2011 Jul;121(7):2750-67.
DOI: 10.1172/JCI45014
Derakhshan F, Reis-Filho JS. Pathogenesis of Triple-Negative Breast Cancer. Annu Rev Pathol. 2022;17:181-204.
DOI: 10.1146/annurev-pathol-042420-093238
Burstein MD, Tsimelzon A, Poage GM, Covington KR, Contreras A, Fuqua SA, Savage MI, Osborne CK, Hilsenbeck SG, Chang JC, Mills GB, Lau CC, Brown PH. Comprehensive genomic analysis identifies novel subtypes and targets of triple-negative breast cancer. Clin Cancer Res. 2015 Apr 1;21(7):1688-98.
DOI: 10.1158/1078-0432.CCR-14-0432
Maqbool M, Bekele F, Fekadu G. Treatment Strategies Against Triple-Negative Breast Cancer: An Updated Review. Breast Cancer (Dove Med Press). 2022;14:15-24. Published 2022 Jan 11.
DOI: 10.2147/BCTT.S348060
Szekely B, Bossuyt V, Li X, et al. Immunological differences between primary and metastatic breast cancer. Ann Oncol. 2018;29(11):2232-2239.
DOI: 10.1093/annonc/mdy399
Tutt A, Tovey H, Cheang MCU, Kernaghan S, Kilburn L, Gazinska P, et al. Carboplatin in BRCA1/2-mutated and triple-negative breast cancer BRCAness subgroups: The TNT Trial. Nat Med [Internet]. 2018;24(5):628–37. Available from: http://dx.doi.org/10.1038/s41591-018-0009-7
DOI: 10.1038/s41591-018-0009-7
Schmid, P., Rugo, H. S., Adams, S., Schneeweiss, A., Barrios, C. H., Iwata, H., Diéras, V., Henschel, V., Molinero, L., Chui, S. Y., Maiya, V., Husain, A., Winer, E. P., Loi, S., Emens, L. A., & IMpassion130 Investigators. (2020). Atezolizumab plus nab-paclitaxel as first-line treatment for unresectable, locally advanced or metastatic triple-negative breast cancer (IMpassion130): updated efficacy results from a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet Oncology, 21(1), 44–59. https://doi.org/10.1016/S1470-2045(19)30689-8
DOI: 10.1016/S1470-2045(19)30689-8
Cortes J, Cescon DW, Rugo HS, et al. Pembrolizumab plus chemotherapy versus placebo plus chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer (KEYNOTE-355): a randomised, placebo-controlled, double-blind, phase 3 clinical trial. Lancet. 2020;396(10265):1817-1828.
DOI: 10.1016/S0140-6736(20)32531-9
Bardia A, Hurvitz SA, Tolaney SM, Loirat D, Punie K, Oliveira M, et al. Sacituzumab Govitecan in Metastatic Triple-Negative Breast Cancer. New England Journal of Medicine. 2021;384(16):1529–41
DOI: 10.1056/NEJMoa2028485
Drago JZ, Modi S, Chandarlapaty S. Unlocking the potential of antibody-drug conjugates for cancer therapy. Nat Rev Clin Oncol [Internet]. 2021 ;18(6):327–44
DOI: 10.1038/s41571-021-00470-8
Pauls M, Chia S, LeVasseur N. Current and new novel combination treatments for metastatic triple-negative breast cancer. Curr Oncol [Internet]. 2022;29(7):4748–67
DOI: 10.3390/curroncol29070377
Shastry M, Jacob S, Rugo HS, Hamilton E. Antibody-drug conjugates targeting TROP-2: Clinical development in metastatic breast cancer. Breast [Internet]. 2022;66(August):169–77. Available from: https://doi.org/10.1016/j.breast.2022.10.007
DOI: 10.1016/j.breast.2022.10.007
Krop I, Juric D, Shimizu T, Tolcher A, Spira A, Mukohara T, et al. Abstract GS1-05: Datopotamab deruxtecan in advanced/metastatic HER2- breast cancer: Results from the phase 1 TROPION-PanTumor01 study. Cancer Res [Internet]. 2022 Feb 15;82(4_Supplement):GS1-05-GS1-05. Available from: https://doi.org/10.1158/1538-7445.SABCS21-GS1-05
DOI: 10.1158/1538-7445.SABCS21-GS1-05
Khadela A, Soni S, Shah AC, Pandya AJ, Megha K, Kothari N, et al. Unveiling the antibody–drug conjugates portfolio in battling Triple-negative breast cancer: Therapeutic trends and Future horizon. Medical Oncology [Internet]. 2023;40(1):1–17. Available from: https://doi.org/10.1007/s12032-022-01884-9
DOI: 10.1007/s12032-022-01884-9
Nandini D, Jennifer A, Pradip D. Therapeutic strategies for metastatic triple-negative breast cancers: From negative to positive. Pharmaceuticals (Basel) [Internet]. 2021 ;14(5):455.
DOI: 10.3390/ph14050455
Vahdat LT, Schmid P, Forero-Torres A, Blackwell K, Telli ML, Melisko M, et al. Glembatumumab vedotin for patients with metastatic, gpNMB overexpressing, triple-negative breast cancer (“METRIC”): a randomized multicenter study. NPJ Breast Cancer. 2021;7(1).
DOI: 10.1038/s41523-021-00244-6
Suthe SR, Yao HP, Weng TH, Hu CY, Feng L, Wu ZG, et al. RON receptor tyrosine kinase as a therapeutic target for eradication of triple-negative breast cancer: Efficacy of anti-RON ADC ZT/G4-MMAE. Mol Cancer Ther. 2018;17(12):2654–64
DOI: 10.1158/1535-7163.MCT-18-0252
Modi S, Jacot W, Yamashita T, Sohn J, Vidal M, Tokunaga E, et al. Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer. New England Journal of Medicine. 2022;387(1):9–20
DOI: 10.1056/NEJMoa2203690
Schmid P, Jung KH, Wysocki PJ, et al. Datopotamab deruxtecan (Dato-DXd) + durvalumab (D) as first-line (1L) treatment for unresectable locally advanced/metastatic triple-negative breast cancer (a/mTNBC): Initial results from BEGONIA, a phase Ib/II study. Ann Oncol 2022;33(suppl_3):S194–S223.
DOI: 10.1016/j.annonc.2022.03.185
Seagen Inc. Single Arm, Open Label Phase 1b/2 Study of SGN-LIV1A in Combination With Pembrolizumab for First Treatments of Patients With Unresectable Locally-Advanced or Metastasic Triple-Negative Breast Cancer. ClinicalTrials.gov Identifier: NCT03310957 [Internet]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT03310957
Murai J, Zhang Y, Morris J, Ji J, Takeda S, Doroshow JH, et al. Rationale for poly(ADP-ribose) polymerase (PARP) inhibitors in combination therapy with camptothecins or temozolomide based on PARP trapping versus catalytic inhibition. J Pharmacol Exp Ther [Internet]. 2014 ;349(3):408–16.
DOI: 10.1124/jpet.113.210146
Bardia A. Phase 1b/2 Study to Evaluate Antibody-Drug Conjugate Sacituzumab Govitecan in Combination With PARP Inhibitor Talazoparib in Patients With Metastatic Breast Cancer. ClinicalTrials.gov Identifier: NCT04039230 [Internet]. Available from: https://www.clinicaltrials.gov/ct2/show/NCT04039230
Chang DY, Ma WL, Lu YS. Role of alpelisib in the treatment of pik3ca-mutated breast cancer: Patient selection and clinical perspectives. Ther Clin Risk Manag. 2021;17:193–207.
DOI: 10.2147/TCRM.S251668
Sharma P. Phase I Trial of Alpelisib Plus Sacituzumab Govitecan in Patients with Metastatic or Locally Recurrent HER2-Negative Breast Cancer. ClinicalTrials.gov Identifier: NCT05143229 [Internet]. Available from: https://clinicaltrials.gov/ct2/show/NCT05143229
Yang EY, Shah K. Nanobodies: Next Generation of Cancer Diagnostics and Therapeutics. Front Oncol. 2020;10(July)
DOI: 10.3389/fonc.2020.01182
Juan A, Cimas FJ, Bravo I, Pandiella A, Ocaña A, Alonso-Moreno C. Antibody conjugation of nanoparticles as therapeutics for breast cancer treatment. Int J Mol Sci. 2020;21(17):1–21
DOI: 10.3390/ijms21176018
Landry I, Sumbly V, Vest M. Advancements in the Treatment of Triple-Negative Breast Cancer: A Narrative Review of the Literature. Cureus. 2022;14(2):1–15.
DOI: 10.7759/cureus.21970
Pfizer. A Phase 3, Randomized, International Study Comparing the Efficacy and Safety of Enzalutamide in Combination With Paclitaxel Chemotherapy or as Monotherapy Versus Placebo With Paclitaxel in Patients With Advanced, Diagnostic-Positive, Triple-Negati. ClinicalTrials.gov Identifier: NCT02929576 [Internet]. Available from: https://clinicaltrials.gov/ct2/show/NCT02929576
Schmid P, Abraham J, Chan S, Wheatley D, Brunt AM, Nemsadze G, Baird RD, Park YH, Hall PS, Perren T, Stein RC, Mangel L, Ferrero JM, Phillips M, Conibear J, Cortes J, Foxley A, de Bruin EC, McEwen R, Stetson D, Dougherty B, Sarker SJ, Prendergast A, McLaughlin-Callan M, Burgess M, Lawrence C, Cartwright H, Mousa K, Turner NC. Capivasertib Plus Paclitaxel Versus Placebo Plus Paclitaxel As First-Line Therapy for Metastatic Triple-Negative Breast Cancer: The PAKT Trial. J Clin Oncol. 2020 Feb 10;38(5):423-433.
DOI: 10.1200/JCO.19.00368
Dent R et al, SABCS 2020, #abstract GS3-04
Robson ME, Tung N, Conte P, Im SA, Senkus E, Xu B, et al. OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician’s choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer. Annals of Oncology. 2019;30(4):558–66.
DOI: 10.1093/annonc/mdz012
Litton JK, Hurvitz SA, Mina LA, Rugo HS, Lee KH, Gonçalves A, et al. Talazoparib versus chemotherapy in patients with germline BRCA1/2-mutated HER2-negative advanced breast cancer: final overall survival results from the EMBRACA trial. Annals of Oncology. 2020;31(11):1526–35
DOI: 10.1016/j.annonc.2020.08.2098
Tung NM, Garber JE. BRCA1/2 testing: therapeutic implications for breast cancer management. Br J Cancer. 2018 Jul;119(2):141-152.
DOI: 10.1038/s41416-018-0127-5
Barchiesi G, Roberto M, Verrico M, Vici P, Tomao S, Tomao F. Emerging Role of PARP Inhibitors in Metastatic Triple Negative Breast Cancer. Current Scenario and Future Perspectives. Front Oncol. 2021;11(November):1–16
DOI: 10.3389/fonc.2021.769280
Domchek SM, Postel-Vinay S, Im SA, Park YH, Delord JP, Italiano A, et al. Olaparib and durvalumab in patients with germline BRCA-mutated metastatic breast cancer (MEDIOLA): an open-label, multicentre, phase 1/2, basket study. Lancet Oncol [Internet]. 2020;21(9):1155–64. Available from: http://dx.doi.org/10.1016/S1470-2045(20)30324-7
DOI: 10.1016/S1470-2045(20)30324-7
Tesaro. Phase 1/2 Clinical Study of Niraparib in Combination With Pembrolizumab (MK-3475) in Patients With Advanced or Metastatic Triple-Negative Breast Cancer and in Patients With Recurrent Ovarian Cancer. ClinicalTrials.gov Identifier: NCT02657889 [Internet]. Available from: https://clinicaltrials.gov/ct2/show/NCT02657889
Diéras V, Han HS, Kaufman B, Wildiers H, Friedlander M, Ayoub JP, et al. Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol. 2020;21(10):1269–82
DOI: 10.1016/S1470-2045(20)30447-2
AstraZeneca. A Phase II, Open Label, Randomised, Multi-centre Study to Assess the Safety and Efficacy of Agents Targeting DNA Damage Repair in Combination With Olaparib Versus Olaparib Monotherapy in the Treatment of Metastatic Triple Negative Breast Cancer Patients Stratified by Alterations in Homologous Recombinant Repair (HRR)-Related Genes (Including BRCA1/2) (VIOLETTE). ClinicalTrials.gov Identifier: NCT03330847 [Internet]. Available from: https://clinicaltrials.gov/ct2/show/NCT03330847
Won KA, Spruck C. Triple negative breast cancer therapy: Current and future perspectives. Int J Oncol. 2020;57(6):1245–61
DOI: 10.3892/ijo.2020.5135
Hobbs E. A Phase II,Open-Label, Study of Olaparib in Combination With Either Durvalumab (MEDI4736), Selumetinib or Capivasertib, or Ceralasertib Monotherapy in Patients With Metastatic Triple-Negative Breast Cancer. ClinicalTrials.gov Identifier: NCT03801369 [Internet]. Available from: https://clinicaltrials.gov/ct2/show/NCT03801369
Dorling L, Carvalho S, Allen J, González-Neira A, Luccarini C, Wahlström C, et al. Breast Cancer Risk Genes — Association Analysis in More than 113,000 Women. New England Journal of Medicine. 2021;384(5):428–39
DOI: 10.1056/NEJMoa1913948
Tung NM, Robson ME, Ventz S, Santa-Maria CA, Nanda R, Marcom PK, Shah PD, Ballinger TJ, Yang ES, Vinayak S, Melisko M, Brufsky A, DeMeo M, Jenkins C, Domchek S, D'Andrea A, Lin NU, Hughes ME, Carey LA, Wagle N, Wulf GM, Krop IE, Wolff AC, Winer EP, Garber JE. TBCRC 048: Phase II Study of Olaparib for Metastatic Breast Cancer and Mutations in Homologous Recombination-Related Genes. J Clin Oncol. 2020 Dec 20;38(36):4274-4282.
DOI: 10.1200/JCO.20.02151
Patsouris A, Diop K, Tredan O, Nenciu D, Gonçalves A, Arnedos M, et al. Rucaparib in patients presenting a metastatic breast cancer with homologous recombination deficiency, without germline BRCA1/2 mutation. Eur J Cancer. 2021;159:283–95.
DOI: 10.1016/j.ejca.2021.09.028
Keenan TE, Tolaney SM. Role of immunotherapy in triple-negative breast cancer. JNCCN Journal of the National Comprehensive Cancer Network. 2020;18(4):479–89.
DOI: 10.6004/jnccn.2020.7554
Tolaney SM, Kalinsky K, Kaklamani VG, D’Adamo DR, Aktan G, Tsai ML, et al. Eribulin plus pembrolizumab in patients with metastatic triple-negative breast cancer (ENHANCE 1): A phase Ib/II study. Clinical Cancer Research. 2021;27(11):3061–8
DOI: 10.1158/1078-0432.CCR-20-4726
Voorwerk L, Slagter M, Horlings HM, Sikorska K, van de Vijver KK, de Maaker M, et al. Immune induction strategies in metastatic triple-negative breast cancer to enhance the sensitivity to PD-1 blockade: the TONIC trial. Nat Med [Internet]. 2019;25(6):920–8. Available from: http://dx.doi.org/10.1038/s41591-019-0432-4
DOI: 10.1038/s41591-019-0432-4
Adams S, Othus M, Patel SP, Miller KD, Chugh R, Schuetze SM, et al. A Multicenter Phase II Trial of Ipilimumab and Nivolumab in Unresectable or Metastatic Metaplastic Breast Cancer: Cohort 36 of Dual Anti–CTLA-4 and Anti–PD-1 Blockade in Rare Tumors (DART, SWOG S1609). Clinical Cancer Research. 2022;28(2):271–8
DOI: 10.1158/1078-0432.CCR-21-2182
Li L, Zhang F, Liu Z, Fan Z. Immunotherapy for Triple-Negative Breast Cancer: Combination Strategies to Improve Outcome. Cancers (Basel). 2023;15(1)
DOI: 10.3390/cancers15010321
Schmid P, Savas P, Espinosa E, Boni V, Italiano A, White S, et al. Abstract PS12-28: Phase 1b study evaluating a triplet combination of ipatasertib (IPAT), atezolizumab, and a taxane as first-line therapy for locally advanced/metastatic triple-negative breast cancer (TNBC). Cancer Res [Internet]. 2021 Feb 15;81(4_Supplement):PS12-28-PS12-28. Available from: https://doi.org/10.1158/1538-7445.SABCS20-PS12-28
DOI: 10.1158/1538-7445.SABCS20-PS12-28
Brufsky A, Kim SB, Zvirbule, Eniu A, Mebis J, Sohn JH, et al. A phase II randomized trial of cobimetinib plus chemotherapy, with or without atezolizumab, as first-line treatment for patients with locally advanced or metastatic triple-negative breast cancer (COLET): primary analysis. Annals of Oncology [Internet]. 2021;32(5):652–60. Available from: https://doi.org/10.1016/j.annonc.2021.01.065.
DOI: 10.1016/j.annonc.2021.01.065
Zhou Y, Tian Q, Wang B, Yang J, Zhao S, Yang J. The prognostic significance of TILs as a biomarker in triple-negative breast cancer: what is the role of TILs in TME of TNBC? Eur Rev Med Pharmacol Sci. 2021;2885–97
Santisteban M, Solans BP, Hato L, Urrizola A, Mejías LD, Salgado E, et al. Final results regarding the addition of dendritic cell vaccines to neoadjuvant chemotherapy in early HER2-negative breast cancer patients: clinical and translational analysis. Ther Adv Med Oncol. 2021;13(August):1–14.
DOI: 10.1177/17588359211064653
Song N, Guo H, Ren J, Hao S, Wang X. Synergistic anti-tumor effects of dasatinib and dendritic cell vaccine on metastatic breast cancer in a mouse model. Oncol Lett. 2018;15(5):6831–8
Wang X, Collet L, Rediti M, Debien V, De Caluwé A, Venet D, et al. Predictive Biomarkers for Response to Immunotherapy in Triple Negative Breast Cancer: Promises and Challenges. J Clin Med. 2023;12(3).
DOI: 10.3390/jcm12030953

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