Current approaches to the diagnosis and treatment of metastatic triple-negative breast cancer

Lazakovich A.A., Dzhelyalov E.S., Sereda O.A., Vats A.B., Shaikhelislamova L.F., Zhurov A.S., Akhmedov R.M., Semiletova Yu.V., Belousov A.M., Dashyan G.A.

Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia

Metastatic triple-negative breast cancer (mTNBC) is characterized by an aggressive course and previously limited treatment options. However, in recent years, the treatment paradigm has undergone revolutionary changes, shifting from non-specific chemotherapy to a personalized, biomarker-based approach. This review provides a detailed analysis of current strategies for the diagnosis and treatment of mTNBC. The critical importance of comprehensive molecular testing, including determination of PD-L1 status, germline mutations in the BRCA1/2 genes, and HER2 expression (including HER2-low status) for choosing the optimal strategy is emphasized. This article puts focus on the strategic sequencing of different classes of targeted agents, taking into account their mechanisms of action and application sites. The article provides not only information on available options but also a practical algorithm for decision-making based on the latest evidence-based medicine and a clear hierarchy of biomarkers.

For citations: Lazakovich A.A., Dzhelyalov E.S., Sereda O.A., Vats A.B., Shaikhelislamova L.F., Zhurov A.S., Akhmedov R.M., Semiletova Yu.V., Belousov A.M., Dashyan G.A. Current approaches to the diagnosis and treatment of metastatic triple-negative breast cancer. Pharmateca. 2025;32(9):207-216. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.9.207-216

Authors’ contribution: All authors made significant contributions to the concept and preparation of the article, read and approved the final version before publication. The major contributors are as follows: A.A. Lazakovich, O.A. Sereda, and L.F. Shaikhelislamova – data collection, data analysis, and article writing. G.A. Dashyan, A.M. Belousov, E.S. Dzhelyalov – scientific consultation, editing the article. R.M. Akhmedov, A.S. Zhurov, A.B. Vats, Yu.V. Semiletova – review of publications on the topic of the article.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.

Keywords

About the Authors

Alina A. Lazakovich, Oncologist, Oncology Department No. 1, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University,
St. Petersburg, Russia; dr.lazakovich@gmail.com, ORCID: https://orcid.org/0009-0007-3112-8081 (corresponding author)
Garik A. Dashyan, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0001-6183-9764
Ernest S. Dzhelyalov, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0002-2571-243X
Olga A. Sereda, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0001-7553-2026
Anna B. Vats, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0009-0000-0450-0166
Laysan F. Shaykhelislamova, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0001-9623-3877
Aleksandr S. Zhurov, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0009-0004-7511-2952
Ruslan M. Akhmedov, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0003-3348-4251
Yulia V. Semiletova, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0001-5706-250X
Aleksandr M. Belousov, Pirogov Clinic of High Medical Technologies, Saint Petersburg State University, St. Petersburg, Russia; ORCID: https://orcid.org/0000-0002-2274-8170

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