Il tempo guadagnato, a cosa dare valore?
La malattia triple negative
Antonella LaiOutline
1. Introduction
2. Metastatic breast cancer
3. Goals of neoadjuvant therapy; pCR as an endpoint in TNBC
4. How to improve pCR in TNBC
• Optimizing taxanes in TNBC
• DNA damaging agents
• Immunotherapy
5. Is there a role for adjuvant therapy in TNBC in the future?
6. Take home messages
Triple negative breast cancer
TNBC is histologically heterogeneous
Outline
1. Introduction
2. Metastatic breast cancer
3. Goals of neoadjuvant therapy; pCR as an endpoint in TNBC
4. How to improve pCR in TNBC
• Optimizing taxanes in TNBC
• DNA damaging agents
• Immunotherapy
5. Is there a role for adjuvant therapy in TNBC in the future?
6. Take home messages
Metastatic TNBC: still a very poor outcome
Decision tree?
Goals of the treatment in ABC
Early treatment of TNBC is the BEST CHANCE
of cure!!!!
Outline
1. Introduction
2. Metastatic breast cancer
3. Goals of neoadjuvant therapy; pCR as an endpoint in TNBC
4. How to improve pCR in TNBC
• Optimizing taxanes in TNBC
• DNA damaging agents
• Immunotherapy
5. Is there a role for adjuvant therapy in TNBC in the future?
6. Take home messages
Goals of neoadjuvant therapy in breast cancer
• Make tumours more operable, increase the rate of breast conserving surgeries
• Probably, to improve prognosis of certain disease subtypes (i.e HER 2 +)
• Allow patient to start treatment earlier
• Have a better idea of prognosis based on response to neadj treatment
• Improve DFS and OS using pathological response rate for selection of
subsequent treatment in individual patients
Goals of neoadjuvant therapy in breast cancer
• Make tumours more operable, increase the rate of breast conserving surgeries
• Probably, to improve prognosis of certain disease subtypes (i.e HER 2 +)
• Allow patient to start treatment earlier
• Have a better idea of prognosis based on response to neadj treatment
• Improve DFS and OS using pathological response rate for selection of
subsequent treatment in individual patients
pCR as a surrogate endpoint for long term
outcomes
Stromal TILs and survival outcome in residual TNBC
Following neoadjuvant chemotherapy
Outline
1. Introduction
2. Metastatic breast cancer
3. Goals of neoadjuvant therapy; pCR as an endpoint in TNBC
4. How to improve pCR in TNBC
• Optimizing taxanes in TNBC
• DNA damaging agents
• Immunotherapy
5. Is there a role for adjuvant therapy in TNBC in the future?
6. Take home messages
