Câncer de mama triplo negativo: avanços e perspectivas nos aspectos epidemiológicos, clínicos e terapêuticos
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Nov 19, 2022
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Resumo
Objetivo: Analisar os avanços e perspectivas dos aspectos epidemiológicos, clínicos e terapêuticos do Câncer de Mama Triplo Negativo (CMTN). Métodos: Trata-se de uma revisão integrativa da literatura, entre 2017-2021, a partir das bases de dados PubMed, SciELO e LILACS por meio de descritores nos idiomas português, inglês e espanhol, com texto completo disponível. Foram identificados 801 artigos, destes, 366 artigos obedeceram aos critérios de inclusão e exclusão. Após leitura e análise crítica, foram elegidos 35 artigos para o universo amostral desta revisão. Resultados: O tratamento padrão atual para o CMTN inicial baseia-se em quimioterapias principalmente a base de antraciclinas e taxanos, inibidores da Poli (adp-ribose) Polimerase (PARP) para mulheres com CMTN Metastático (mCMTN) com mutação do Breast Cancer Gene (BRCA) e uso de imunoterapias. No entanto, novas propostas inovadoras surgiram, como vacinas, biomarcadores inéditos e terapias antiangiogênicas que ainda estão em desenvolvimento. A prevalência desse tipo neoplásico foi maior em mulheres com faixa etária em torno de 50 anos; raça negra; com presença da mutação BRCA1. Considerações finais: Constatou-se que apesar de alguns estudos trazerem propostas com ganhos relevantes (>10 meses) em Sobrevida Global (SG), ainda se faz necessário alcançar novos avanços em aspectos clínicos e terapêuticos no CMTN.
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Como Citar
GusmãoL. C., RochaT. S., LuzN. B. N., FreitasA. R., & OliveiraG. L. P. de. (2022). Câncer de mama triplo negativo: avanços e perspectivas nos aspectos epidemiológicos, clínicos e terapêuticos. Revista Eletrônica Acervo Saúde, 15(11), e11213. https://doi.org/10.25248/reas.e11213.2022
Seção
Revisão Bibliográfica
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Referências
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8. CHEN Y, et al. Platinum‐based chemotherapy in advanced triple‐negative breast cancer: A multicenter real‐world study in China. International Journal of Cancer, 2020;147: 3490–3499.
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12. FERREIRA EN, et al. Influence of BRCA1 germline mutations in the somatic mutational burden of triple-negative breast cancer. Translational oncology, 2019;12: 1453-1460.
13. GHEBEH H, et al. Weekly Paclitaxel given concurrently with Durvalumab has a favorable safety profile in triple-negative metastatic breast cancer. Scientific Reports, 2021; 11.
14. HAIDERALI A, et al. Real-world treatment patterns and effectiveness outcomes in patients with early-stage triple-negative breast cancer. Future Oncology, 2021;17: 3819-3831.
15. HUANG C, et al. Globo H-KLH vaccine adagloxad simolenin (OBI-822)/OBI-821 in patients with metastatic breast cancer: phase II randomized, placebo-controlled study. Journal for ImmunoTherapy of Cancer, 2020; 8: e000342.
16. INOUE K, et al. TS-1 add-on therapy in Japanese patients with triple-negative breast cancer after neoadjuvant or adjuvant chemotherapy: a feasibility study. Investigational New Drugs, 2019; 38: 140–147.
17. KIM K, et al. Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23. Cancer Research and Treatment, 2018;50: 1316–1323.
18. KRASNIQI E, et al. Second-line Eribulin in Triple Negative Metastatic Breast Cancer patients. Multicentre Retrospective Study: The TETRIS Trial. International Journal of Medical Sciences, 2021;18: 2245–2250.
19. LI J, et al. Adjuvant Capecitabine With Docetaxel and Cyclophosphamide Plus Epirubicin for Triple-Negative Breast Cancer (CBCSG010): An Open-Label, Randomized, Multicenter, Phase III Trial. Journal of Clinical Oncology, 2020;38: 1774–1784.
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21. LOIBL S, et al. A randomised phase II study investigating durvalumab in addition cancer anthracycline taxane-based neoadjuvant therapy in early triple-negative breast câncer: clinical results and biomarker analysis of GeparNuevo study. Annals of Oncology, 2019;30: 1279-1288.
22. LOIBL S, et al. Survival analysis of carboplatin added to an anthracycline/taxane-based neoadjuvant chemotherapy and HRD score as predictor of response—final results from GeparSixto. Annals of Oncology, 2018;29: 2341–2347.
23. MANDUJANO-GUIZADO G, et al. Características clínicas e histopatológicas associadas a pacientes com câncer de mama triplo negativo em um hospital de referência peruano, 2012-2018. Revista da Faculdade de Medicina Humana, 2019; 19: 53-59.
24. MARTÍNEZ BEH, FERNÁNDEZ HG. Caracterización del cáncer de mama triple negativo. Revista de Enfermedades no Transmisibles Finlay, 2020;10: 259-268.
25. MARTINS LC, et al. Padrão de metástase no câncer de mama triplo negativo. Ver Bras Mastologia, 2017;27: 8-14.
26. OMILIAN AR, et al. Somatic mutations of triple-negative breast cancer: a comparison between Black and White women. Breast Cancer Research and Treatment, 2020; 82: 503–509.
27. PELLEGRINO B, et al. Phase II study of eribulin in combination with gemcitabine for the treatment of patients with locally advanced or metastatic triple negative breast cancer (ERIGE trial). Clinical and pharmacogenetic results on behalf of the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC). ESMO Open, 2021;6: 100019.
28. ROCHE. Câncer de mama tem primeira imunoterapia aprovada no Brasil. 2019. Disponível em https://www.roche.com.br/pt/imprensa/anvisa-aprova-primeiro-teste-para-identificar-pacientes-com-cancer-de-mama-triplo-negativo-metastatico-elegiveis-a-imunoterapia.html. Acessado em: 20 jul. 2022.
29. SANGES F, et al. Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis. BMC Cancer, 2020;20.
30. SCHMID P, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast câncer. New England Journal of Medicine,2018;379: 2108-2121.
31. SHARMA P, et al. Randomized Phase II Trial of Anthracycline-free and Anthracycline-containing Neoadjuvant Carboplatin Chemotherapy Regimens in Stage I–III Triple-negative Breast Cancer (NeoSTOP). Clinical Cancer Research, 2021;27: 975–982.
32. SRIMUNINNIMIT V, et al. Real-life clinical pattern, management, and survival in Thai patients with early-stage or metastatic triple-negative breast cancer. PLOS ONE, 2020;13: e0209040.
33. SYMONDS L, et al. Combined Targeted Therapies for First-line Treatment of Metastatic Triple Negative Breast Cancer—A Phase II Trial of Weekly Nab-Paclitaxel and Bevacizumab Followed by Maintenance Targeted Therapy With Bevacizumab and Erlotinib. Clinical breast cancer, 2019; 19: e283-e296.
34. TAN A, et al. Efficacy and safety of continuous infusion of Rh-endostatin combined with platinum-based chemotherapy for advanced triple-negative breast cancer. Annals of Palliative Medicine, 2021;10: 12101–12112.
35. TOH U, et al. Early phase II study of mixed 19‐peptide vaccine monotherapy for refractory triple‐negative breast cancer. Cancer Science, 2020;111: 2760–2769.
36. TRAINA TA, et al. Enzalutamide for the treatment of androgen receptor–expressing triple-negative breast cancer. Journal of clinical oncology, 2018;36: 884.
37. WANG X, et al. Effect of Capecitabine Maintenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment The SYSUCC-001 Randomized Clinical Trial. JAMA, 2021;325(1): 50-58.
38. WANG Y, et al. Clinical observation on the effect of Chinese medicine-“TCM formula” intervention on recurrence and metastasis of triple negative breast cancer. Complementary therapies in medicine. 2020;52: 102456.
39. YU K, et al. Effect of adjuvant paclitaxel and carboplatin on survival in women with triple-negative breast cancer: a phase 3 randomized clinical trial. JAMA Oncology, 2020;6: 1390-1396.
40. YUAN Y, et al. Phase II Trial of Neoadjuvant Carboplatin and Nab-Paclitaxel in Patients with Triple-Negative Breast Cancer. The Oncologist, 2020;26: e382–e393.
2. BALKENHOL MCA, et al. Optimized tumour infiltrating lymphocyte assessment for triple negative breast cancer prognostics. The Breast, 2021;56: 78–87.
3. BARDIA A, et al. Biomarker analyses in the phase III ASCENT study of sacituzumab govitecan versus chemotherapy in patients with metastatic triple-negative breast cancer. Annals of Oncology, 2021;32: 1148-1156.
4. BRASIL. Instituto Nacional de Câncer (INCA). Estimativa 2020: incidência de câncer no Brasil. 2022. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/estimativa-2020-incidencia-de-cancer-no-brasil.pdf. Acesso em: 19 ago. 2022.
5. BRUFSKY A, et al. A phase II randomized trial of cobimetinib plus chemotherapy, with or without atezolizumab, as first-line treatment for patients with locally advanced or metastatic triple-negative breast câncer (COLET): primary analysis. Annals of Oncology, 2021;32: 652-660.
6. CARDILLO TM, et al. Sacituzumab govitecan (IMMU-132), an anti-Trop-2/SN-38 antibody–drug conjugate: characterization and efficacy in pancreatic, gastric, and other cancers. Bioconjugate chemistry, 2015;26(5): 919-931.
7. CAZZANIGA ME, et al. Metronomic chemotherapy (mCHT) in metastatic triple-negative breast cancer (TNBC) patients: results of the VICTOR-6 study. Breast Cancer Research and Treatment, 2021;90: 415–424.
8. CHEN Y, et al. Platinum‐based chemotherapy in advanced triple‐negative breast cancer: A multicenter real‐world study in China. International Journal of Cancer, 2020;147: 3490–3499.
9. COSTA REAR, et al. Prognostic factors in triple-negative breast cancer: a retrospective cohort. Revista da Associação Médica Brasileira, 2021;67: 950-957.
10. EMENS LA, et al. First-line atezolizumab plus nab-paclitaxel for unresectable, locally advanced, or metastatic triple-negative breast câncer: Impassion130 final overall survival analysis. Annals of Oncology, 2021;32: 983-993.
11. FENN K, et al. Phase 1 Study of Erlotinib and Metformin in Metastatic Triple-Negative Breast Cancer. Clinical Breast Cancer, 2020;20: 80–86.
12. FERREIRA EN, et al. Influence of BRCA1 germline mutations in the somatic mutational burden of triple-negative breast cancer. Translational oncology, 2019;12: 1453-1460.
13. GHEBEH H, et al. Weekly Paclitaxel given concurrently with Durvalumab has a favorable safety profile in triple-negative metastatic breast cancer. Scientific Reports, 2021; 11.
14. HAIDERALI A, et al. Real-world treatment patterns and effectiveness outcomes in patients with early-stage triple-negative breast cancer. Future Oncology, 2021;17: 3819-3831.
15. HUANG C, et al. Globo H-KLH vaccine adagloxad simolenin (OBI-822)/OBI-821 in patients with metastatic breast cancer: phase II randomized, placebo-controlled study. Journal for ImmunoTherapy of Cancer, 2020; 8: e000342.
16. INOUE K, et al. TS-1 add-on therapy in Japanese patients with triple-negative breast cancer after neoadjuvant or adjuvant chemotherapy: a feasibility study. Investigational New Drugs, 2019; 38: 140–147.
17. KIM K, et al. Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23. Cancer Research and Treatment, 2018;50: 1316–1323.
18. KRASNIQI E, et al. Second-line Eribulin in Triple Negative Metastatic Breast Cancer patients. Multicentre Retrospective Study: The TETRIS Trial. International Journal of Medical Sciences, 2021;18: 2245–2250.
19. LI J, et al. Adjuvant Capecitabine With Docetaxel and Cyclophosphamide Plus Epirubicin for Triple-Negative Breast Cancer (CBCSG010): An Open-Label, Randomized, Multicenter, Phase III Trial. Journal of Clinical Oncology, 2020;38: 1774–1784.
20. LI Q, et al. Low-Dose Anti-Angiogenic Therapy Sensitizes Breast Cancer to PD-1 Blockade. Clinical Cancer Research, 2020;26: 1712–1724.
21. LOIBL S, et al. A randomised phase II study investigating durvalumab in addition cancer anthracycline taxane-based neoadjuvant therapy in early triple-negative breast câncer: clinical results and biomarker analysis of GeparNuevo study. Annals of Oncology, 2019;30: 1279-1288.
22. LOIBL S, et al. Survival analysis of carboplatin added to an anthracycline/taxane-based neoadjuvant chemotherapy and HRD score as predictor of response—final results from GeparSixto. Annals of Oncology, 2018;29: 2341–2347.
23. MANDUJANO-GUIZADO G, et al. Características clínicas e histopatológicas associadas a pacientes com câncer de mama triplo negativo em um hospital de referência peruano, 2012-2018. Revista da Faculdade de Medicina Humana, 2019; 19: 53-59.
24. MARTÍNEZ BEH, FERNÁNDEZ HG. Caracterización del cáncer de mama triple negativo. Revista de Enfermedades no Transmisibles Finlay, 2020;10: 259-268.
25. MARTINS LC, et al. Padrão de metástase no câncer de mama triplo negativo. Ver Bras Mastologia, 2017;27: 8-14.
26. OMILIAN AR, et al. Somatic mutations of triple-negative breast cancer: a comparison between Black and White women. Breast Cancer Research and Treatment, 2020; 82: 503–509.
27. PELLEGRINO B, et al. Phase II study of eribulin in combination with gemcitabine for the treatment of patients with locally advanced or metastatic triple negative breast cancer (ERIGE trial). Clinical and pharmacogenetic results on behalf of the Gruppo Oncologico Italiano di Ricerca Clinica (GOIRC). ESMO Open, 2021;6: 100019.
28. ROCHE. Câncer de mama tem primeira imunoterapia aprovada no Brasil. 2019. Disponível em https://www.roche.com.br/pt/imprensa/anvisa-aprova-primeiro-teste-para-identificar-pacientes-com-cancer-de-mama-triplo-negativo-metastatico-elegiveis-a-imunoterapia.html. Acessado em: 20 jul. 2022.
29. SANGES F, et al. Histologic subtyping affecting outcome of triple negative breast cancer: a large Sardinian population-based analysis. BMC Cancer, 2020;20.
30. SCHMID P, et al. Atezolizumab and nab-paclitaxel in advanced triple-negative breast câncer. New England Journal of Medicine,2018;379: 2108-2121.
31. SHARMA P, et al. Randomized Phase II Trial of Anthracycline-free and Anthracycline-containing Neoadjuvant Carboplatin Chemotherapy Regimens in Stage I–III Triple-negative Breast Cancer (NeoSTOP). Clinical Cancer Research, 2021;27: 975–982.
32. SRIMUNINNIMIT V, et al. Real-life clinical pattern, management, and survival in Thai patients with early-stage or metastatic triple-negative breast cancer. PLOS ONE, 2020;13: e0209040.
33. SYMONDS L, et al. Combined Targeted Therapies for First-line Treatment of Metastatic Triple Negative Breast Cancer—A Phase II Trial of Weekly Nab-Paclitaxel and Bevacizumab Followed by Maintenance Targeted Therapy With Bevacizumab and Erlotinib. Clinical breast cancer, 2019; 19: e283-e296.
34. TAN A, et al. Efficacy and safety of continuous infusion of Rh-endostatin combined with platinum-based chemotherapy for advanced triple-negative breast cancer. Annals of Palliative Medicine, 2021;10: 12101–12112.
35. TOH U, et al. Early phase II study of mixed 19‐peptide vaccine monotherapy for refractory triple‐negative breast cancer. Cancer Science, 2020;111: 2760–2769.
36. TRAINA TA, et al. Enzalutamide for the treatment of androgen receptor–expressing triple-negative breast cancer. Journal of clinical oncology, 2018;36: 884.
37. WANG X, et al. Effect of Capecitabine Maintenance Therapy Using Lower Dosage and Higher Frequency vs Observation on Disease-Free Survival Among Patients With Early-Stage Triple-Negative Breast Cancer Who Had Received Standard Treatment The SYSUCC-001 Randomized Clinical Trial. JAMA, 2021;325(1): 50-58.
38. WANG Y, et al. Clinical observation on the effect of Chinese medicine-“TCM formula” intervention on recurrence and metastasis of triple negative breast cancer. Complementary therapies in medicine. 2020;52: 102456.
39. YU K, et al. Effect of adjuvant paclitaxel and carboplatin on survival in women with triple-negative breast cancer: a phase 3 randomized clinical trial. JAMA Oncology, 2020;6: 1390-1396.
40. YUAN Y, et al. Phase II Trial of Neoadjuvant Carboplatin and Nab-Paclitaxel in Patients with Triple-Negative Breast Cancer. The Oncologist, 2020;26: e382–e393.