Shifting Paradigms in TNBC Treatment: Emerging Alternatives to Capecitabine in the Post-Neoadjuvant Setting

被引:1
作者
Abahssain, Halima [1 ,2 ]
Souadka, Amine [2 ,3 ,4 ]
Alem, Rania [1 ,5 ]
Santoni, Matteo [6 ]
Battelli, Nicola [6 ]
Amela, Eric [1 ]
Lemaire, Antoine [7 ]
Rodriguez, Joseph [7 ]
Errihani, Hassan [2 ,5 ]
机构
[1] Valenciennes Gen Hosp, Oncol & Med Specialties Dept, F-59300 Valenciennes, France
[2] Univ Mohammed V Rabat, Equipe Rech Oncol Translat EROT, Rabat 8007, Morocco
[3] Univ Mohammed V Rabat, Natl Inst Oncol, Surg Oncol Dept, Rabat 8007, Morocco
[4] Ctr Hosp Univ Ibn Sina, Ctr Invest Clin, Rabat 6527, Morocco
[5] Univ Mohammed V Rabat, Natl Inst Oncol, Oncol Dept, Rabat 8007, Morocco
[6] Macerata Hosp, Oncol Unit, I-62100 Macerata, Italy
[7] Valenciennes Gen Hosp, Support Care Dept, F-59300 Valenciennes, France
关键词
triple-negative breast cancer; capecitabine; immunotherapy; PARP inhibitors; antibody-drug conjugates; neoadjuvant therapy; adjuvant therapy; METASTATIC BREAST-CANCER; OPEN-LABEL; CHEMOTHERAPY; CARBOPLATIN; OLAPARIB; PACLITAXEL; DURVALUMAB;
D O I
10.3390/curroncol31070278
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Triple-negative breast cancer (TNBC) remains a clinically challenging subtype due to its aggressive nature and limited treatment options post-neoadjuvant failure. Historically, capecitabine has been the cornerstone of adjuvant therapy for TNBC patients not achieving a pathological complete response (pCR). However, the integration of new modalities such as immunotherapy and PARP inhibitors has prompted a re-evaluation of traditional post-neoadjuvant approaches. Methods: This review synthesizes data from pivotal clinical trials and meta-analyses to evaluate the efficacy of emerging therapies in the post-neoadjuvant setting. We focus on the role of immune checkpoint inhibitors (ICIs), PARP inhibitors (PARPis), and antibody-drug conjugates (ADCs) alongside or in place of capecitabine in TNBC treatment paradigms. Results: The addition of ICIs like pembrolizumab to neoadjuvant regimens has shown increased pCR rates and improved event-free survival, posing new questions about optimal post-neoadjuvant therapies. Similarly, PARPis have demonstrated efficacy in BRCA-mutated TNBC populations, with significant improvements in disease-free survival (DFS) and overall survival (OS). Emerging studies on ADCs further complicate the adjuvant landscape, offering potentially efficacious alternatives to capecitabine, especially in patients with residual disease after neoadjuvant therapy. Discussion: The challenge remains to integrate these new treatments into clinical practice effectively, considering factors such as drug resistance, patient-specific characteristics, and socio-economic barriers. This review discusses the implications of these therapies and suggests a future direction focused on personalized medicine approaches in TNBC. Conclusions: As the treatment landscape for TNBC evolves, the role of capecitabine is being critically examined. While it remains a viable option for certain patient groups, the introduction of ICIs, PARPis, and ADCs offers promising alternatives that could redefine adjuvant therapy standards. Ongoing and future trials will be pivotal in determining the optimal therapeutic strategies for TNBC patients with residual disease post-neoadjuvant therapy.
引用
收藏
页码:3771 / 3782
页数:12
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