Treatments for Triple-Negative Breast Cancer
Triple-negative breast cancer (TNBC) can be more difficult to treat than other types of breast cancer — in part because the cancer behaves differently than other cancers and fewer treatment options exist. Even so, there are several standard treatment options for the disease. There’s also evolving research into new and better treatments for TNBC.
You and your doctor will develop a treatment plan that takes into account genetic factors (like whether you have a BRCA mutation) and the characteristics of the cancer (like PD-L1 status), your preferences, and the types of cancer treatments you may have received in the past if you have metastatic cancer.
Surgery
Depending on the characteristics of the cancer, your doctor may recommend a mastectomy or lumpectomy to remove the cancer.
Radiation therapy
If you have lumpectomy, it’s common to have radiation therapy after surgery. If you have a mastectomy, your doctor may recommend radiation if the cancer is large or has spread to the lymph nodes.
Chemotherapy
Chemotherapy uses one or more medicines to slow or stop the growth of cancer cells. Most people with TNBC receive chemotherapy, like anthracyclines or taxanes. It may be given before surgery, which is called neoadjuvant chemotherapy, or after surgery, which is called adjuvant chemotherapy.
If the TNBC is metastatic and PD-L1-negative, you may be offered chemo as a second option, if a targeted therapy doesn’t work.
Immunotherapy
Immunotherapy medicines stimulate your body’s immune system to attack cancer cells. Keytruda (chemical name: pembrolizumab) is used to treat early-stage triple-negative disease with a high risk of recurrence, as well as PD-L1-positive metastatic triple-negative breast cancer.
Targeted therapy
If you have a BRCA mutation, your doctor may recommend a PARP inhibitor like Lynparza (chemical name: olaparib) or Talzenna (chemical name: talazoparib). These drugs target a protein that helps repair damage in cancer cells, called the PARP protein. Without this protein, cancer cells become too damaged and die off.
If the TNBC is metastatic and PD-L1-negative, you may be prescribed an antibody-drug conjugate, like Trodelvy (chemical name: sacituzumab govitecan-hziy) or Datroway (chemical name: datopotamab deruxtecan-dlnk). Both Trodelvy and Datroway target the Trop-2 protein, which is found in about 80% of breast cancers. Both may be offered before chemotherapy as a first-line treatment, following recent approvals by the FDA.
Why is it so difficult to treat TNBC?
There are multiple factors that make triple-negative breast cancer harder to treat than other types of breast cancer. TNBC tumors have normal levels of the protein HER2 and lack receptors for the hormones estrogen and progesterone, which means standard breast cancer treatments like hormonal therapies and HER2-targeted therapies won’t work.
Some doctors consider TNBC to be more aggressive than other types of breast cancer because it tends to grow and spread faster. Because of this, TNBC has to be treated with systemic therapies — drugs that enter the bloodstream and reach cancer cells throughout the body — like chemotherapy or immunotherapy.
Research on treatments for triple-negative breast cancer
There are many studies looking for new and better treatments for triple-negative breast cancer, including new types of chemotherapy and immunotherapy medicines. Cutting edge research also focuses on the growing potential of antibody-drug conjugates, like Trodelvy, to treat TNBC. If you’re interested in participating in a clinical trial, talk to your doctor about which one is right for you.
Triple-Negative Breast Cancer Treatment: Where Are We?
With guest Lisa Carey, MD, ScM, FASCO
Mar 7, 2025Diagnosis
