Erica L. Mayer and Harold J. Burstein
Triple-negative breast cancer (TNBC) remains defined by what it is not: the breast cancer that lacks a biomarker for rational use of a targeted therapy. Yet chemotherapy, that nonspecific and often toxic anticancer weapon, can be effective against TNBC and remains the sole proven systemic approach for prevention of recurrence and improvement of survival in patients with TNBC. The Oxford Overview meta-analysis has shown unequivocally that combination chemotherapy that includes the alkylator cyclophosphamide augmented by anthracycline and taxane agents is valuable for TNBC.1 Omission of either the anthracycline2 or the taxane3 yields inferior outcomes in TNBC. The question is: Would additional chemotherapy be beneficial?