Metastatic Triple-Negative Breast Cancer — What Clinicians Want to Know

Metastatic triple-negative breast cancer (TNBC) presents significant clinical challenges, as survival improvements lag behind other breast cancer subtypes. The integration of checkpoint inhibitors and antibody-drug conjugates (ADCs) like sacituzumab govitecan and datopotamab deruxtecan represents the current standard for first-line treatment. Because approximately 50% of patients fail to reach second-line therapy, clinicians prioritize highly effective initial regimens. Treatment selection requires balancing patient comorbidities, such as inflammatory bowel disease or ocular surface issues, against the distinct toxicity profiles of these ADCs. For BRCA-mutant patients, sequencing PARP inhibitors alongside ADCs remains a complex, data-driven decision. While androgen receptor-targeted therapies show promise in specific subsets, their efficacy remains under investigation. Ultimately, the focus remains on maximizing early-line therapeutic impact to improve long-term outcomes in a population with limited subsequent treatment options.