Abstract
Triple negative cancer (TNBC) is the most aggressive subtype of breast cancer usually with high proliferative activity. Despite this, the achievement of pathological complete remission (pCR) in early TNBC is not a matter of course, demonstrating the need molecular typing of the disease in order to identify high-risk patients, predictive markers to predict the effect of treatment and the need for new drugs with aimed at personalizing therapy.
Tumor infiltrating lymphocytes (TILs) have in early TNBC has both prognostic and predictive significance indicating chemosensitivity diseases. The absence of clear predictors for the indication of immunotherapy is so far the limit for personalization of immunotherapy in neoadjuvant.
Adjuvant treatment should be offered all women with residual disease after neoadjuvant chemotherapy (NACT). Subtyping the disease could bring new complementary molecules to these women capecitabine, which is still the only choice for this situation.
Molecular examination of PDL1 has opened the door for immunotherapy to enter the first line of metastatic treatment patients whose prognosis was previously infamous. Improving patient survival (OS) provided a combination of nab-paclitaxel and atezolizumab.
Prerequisite for OS improvement i other subtypes of metastatic TNBC are molecular testing and sequential classification other drug molecules targeting eg the PI3K / AKT / MTOR pathway, androgenic receptor (AR) or homologous recombination process.