Current approaches to the diagnosis and treatment of metastatic triple-negative breast cancer

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Abstract

Metastatic triple-negative breast cancer (mTNBC) is characterized by an aggressive course and previously limited treatment options. However, in recent years, the treatment paradigm has undergone revolutionary changes, shifting from non-specific chemotherapy to a personalized, biomarker-based approach. This review provides a detailed analysis of current strategies for the diagnosis and treatment of mTNBC. The critical importance of comprehensive molecular testing, including determination of PD-L1 status, germline mutations in the BRCA1/2 genes, and HER2 expression (including HER2-low status) for choosing the optimal strategy is emphasized. This article puts focus on the strategic sequencing of different classes of targeted agents, taking into account their mechanisms of action and application sites. The article provides not only information on available options but also a practical algorithm for decision-making based on the latest evidence-based medicine and a clear hierarchy of biomarkers.

About the authors

Alina A. Lazakovich

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Author for correspondence.
Email: dr.lazakovich@gmail.com
ORCID iD: 0009-0007-3112-8081

Oncologist, Oncology Department No. 1, Pirogov Clinic of High Medical Technologies

 

Russian Federation, St. Petersburg

Garik A. Dashyan

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0001-6183-9764

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Ernest S. Dzhelyalov

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0002-2571-243X

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Olga A. Sereda

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0001-7553-2026

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Anna B. Vats

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0009-0000-0450-0166

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Laysan F. Shaykhelislamova

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0001-9623-3877

Pirogov Clinic of High Medical Technologies

 

Russian Federation, St. Petersburg

Aleksandr S. Zhurov

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0009-0004-7511-2952

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Ruslan M. Akhmedov

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0003-3348-4251

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Yulia V. Semiletova

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0001-5706-250X

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

Aleksandr M. Belousov

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University

Email: dr.lazakovich@gmail.com
ORCID iD: 0000-0002-2274-8170

Pirogov Clinic of High Medical Technologies

Russian Federation, St. Petersburg

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