Therapeutic challenges in quadruple negative breast cancer

Abstract

Recently, breast cancer (BC) continuously ranks first in the incidence rate of malignant neoplasms in womenworldwide. Quadruple negative BC (QNBC) is a recently identified subtype of triple negative BC (TNBC) presenting with negative androgen receptor expression. QNBC characterization and treatment is fraught with many challenges.There is cumulative evidence suggestingthat QNBC ishighly proliferative and immunogenic, rendering it anideal candidate for cytotoxic chemotherapy and immunotherapy. Several chemotherapeutic agents such as imatinib, cabozantinib, dasatinib, lucitanib,sunitinib, docetaxel, doxorubicin, and cyclophosphamidein QNBCpatients are highlighted. Some subtypes and related pathway proteins are preferentially expressed in QNBC and may act as effective therapeutic targets such as acyl-CoA synthetase4, S-phase kinase associated protein 2, immune checkpoint inhibitors, kinesin family member C1,and epidermal growth factor receptor. Several recent investigations comparing the therapeutic approach to QNBC and TNBC are briefly reviewed. Further more intensive and problem-oriented research in this topic of rising socio-medical importance is needed.

Keywords

• quadruple negative breast cancer
• triple negative breast cancer
• androgen receptor expression
• neoadjuvant chemotherapy
• therapeutic targets