Foundations of Metastatic TNBC: Biology, Prognosis, and the Treatment Paradigm

The panel grounds the discussion in the biology and natural history of metastatic triple-negative breast cancer, framing it as a high-proliferation subtype prone to rapid resistance, in which the first-line setting offers an important opportunity to influence outcomes. Panelists outline a biomarker-driven treatment algorithm stratified by PD-L1 status, germline BRCA status, and prior early-stage therapy, touching on immune checkpoint inhibition, PARP inhibitors, platinum-based chemotherapy, and the role of antibody-drug conjugates across lines of therapy. The conversation then turns to one of the field's most pressing unanswered questions: how to approach treatment after first-line ADCs, where prospective data remain limited and retrospective experience is beginning to inform sequencing strategies. Viewers gain a clear framework for how molecular markers translate into individualized decisions in an aggressive disease where therapeutic windows are often narrow and many patients may not reach later lines of therapy.