Current Frontline Treatment Approaches and Challenges in Advanced TNBC

Current treatment strategies for advanced triple-negative breast cancer (TNBC) have evolved considerably, yet significant challenges remain. Frontline therapy for PD-L1–positive disease commonly includes pembrolizumab plus chemotherapy, which has improved outcomes compared with chemotherapy alone. However, for PD-L1–negative disease, effective options are still limited to chemotherapy, often resulting in short-lived responses.

The panelists highlight the heterogeneity of TNBC, emphasizing how variations in tumor biology, immune microenvironment, and genetic mutations—such as BRCA1/2—affect treatment selection. They also examine the emerging role of antibody-drug conjugates (ADCs) like sacituzumab govitecan, which may soon move into the frontline setting.

Key ongoing challenges include identifying biomarkers beyond PD-L1, managing toxicities, and determining optimal sequencing of therapies as new agents become available. The discussion underscores a shift toward individualized, biomarker-driven care and the need for clinical trial participation to refine future strategies.