Objective To explore the characters and therapy of the triple-negative breast cancer （TNBC）. Methods The pertinent literatures with key words “triple-negative breast cancer”，“diagnosis”，and “therapy” were retrieved and reviewed. Results TNBC was a subtype of breast cancer characterized by negative expressions of estrogen receptor （ER），progesterone receptor （PR），and human epidermal growth factor receptor-2 （HER-2）. The clinicopathologic feature and prognosis of TNBC were distinct from other breast cancer. The age of onset was younger，disease free survival and total survival rate were lower in the patients with TNBC. At present， the therapy guideline was lack of TNBC，which referred to the non-TNBC，including local surgery，systemic chemotherapy，and the target therapy was at the clinical trial stage. Conclusions TNBC is one of heterogeneity characteristics for the breast cancer，which has extra much difference. For improving the TNBC prognosis，we hope that more and more significant markers to TNBC in the future are found，which are useful to make individuation treatment.
Objective To summarize the progress of clinical research on triple-negative breast cancer (TNBC). Methods Domestic and international publications on the study of TNBC in recent years were collected and reviewed. Results The patients with TNBC were younger, and their prognosis was poorer. Besides operation, chemotherapy was the major therapeutic tool for them. Currently the targeted therapy for epidermal growth factor receptor and its signal conducting system was applied to clinical therapy gradually， and it might benefit the patients with TNBC. Conclusion The study on TNBC may bring a new way for therapy.
ObjectiveTo explore expression of epidermal growth factor receptor(EGFR) in triple-negative breast cancer(TNBC). Method The published articles about expression of EGFR in TNBC according to the inclusion and exclusion criteria from PubMed, Elsevier-Science Direct, and Web of Science databases were retrieved. The meta-analysis was performed with RevMan 5.2 software. ResultsA total of 8 articles were eligible for the meta-analysis. Among them, 1 006 patients in the TNBC group and 2 945 cases in the non-TNBC group. The result of meta-analysis showed that the positive rate of EGFR expression in the TNBC group was significantly higher than that in the non-TNBC group(OR=6.57, 95% CI 3.42-12.61, P < 0.000 01). The result of race subgroup analysis showed that the positive rate of EGFR expression of TNBC patients in Caucasian(OR=8.93, 95% CI 4.16-19.17, P < 0.000 01) or Xanthoderm(OR=2.79, 95% CI 0.99-7.89, P=0.05) was significantly increased as compared with non-TNBC patients. ConclusionThe positive rate of EGFR expression in TNBC patients is higher than that of non-TNBC patients, which might become an important marker of TNBC and an effective therapeutic target.
Objective To systematically review the efficacy and safety of immune checkpoint inhibitors combined with chemotherapy in the treatment of triple-negative breast cancer. Methods The PubMed, Cochrane Library, Embase, Web of Science, CNKI, WanFang Data and VIP databases were searched for randomised controlled trials (RCTs) of immune checkpoint inhibitors combined with chemotherapy versus chemotherapy alone for triple-negative breast cancer from inception to 1 April, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. Results A total of 13 RCTs involving 5 416 patients were included. The results of meta-analysis showed that the pathologic complete response rate (pCR) (OR=2.09, 95%CI 1.37 to 3.19, P<0.01), progression-free survival (PFS) (HR=0.75, 95%CI 0.67 to 0.83, P<0.01) and overall survival (OS) (HR=0.85, 95%CI 0.76 to 0.94, P<0.01) were significantly better than those in the control group. The results of subgroup analysis showed that there were statistically significant differences in PFS (HR=0.79, 95%CI 0.72 to 0.87, P<0.01) and OS (HR=0.88, 95%CI 0.79 to 0.98, P=0.02) between PD-L1-positive and PD-L1-negative patients, but there was no statistically significant difference in pCR (OR=1.63, 95%CI 1.32 to 2.02, P=0.36) between PD-L1-positive patients and PD-L1-negative patients. There was a statistically significant difference in pCR between node-positive patients and node-negative patients (OR=1.81, 95%CI 1.38 to 2.37, P=0.03). There was no statistically significant difference in pCR between patients treated with PD-1 inhibitors and PD-L1 inhibitors (OR=2.09, 95%CI 1.37 to 3.19, P=0.32); and there was no significant difference in PFS (HR=0.75, 95%CI 0.67 to 0.83, P=0.19) and OS (HR=0.87, 95%CI 0.79 to 0.96, P=0.99) between patients treated with PD-1 inhibitors and PD-L1 inhibitors. Compared with the control group, the incidence of serious adverse events (RR=1.36, 95%CI 1.09 to 1.70, P<0.01) and immune-related adverse events (RR=2.98, 95%CI 1.66 to 5.35, P=0.03) was higher in the experimental group, and the common immune-related adverse events were hypothyroidism and hyperthyroidism. Conclusion The existing evidence shows that immune checkpoint inhibitors combined with chemotherapy are more effective than chemotherapy alone in the treatment of triple-negative breast cancer, and the combination therapy has a higher incidence of adverse reactions. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.