Metaplastic breast cancer: an old histotype but a current therapeutic problem

Future Oncol. 2021 Mar;17(8):955-963. doi: 10.2217/fon-2020-0490. Epub 2021 Feb 4.

Abstract

Metaplastic breast cancer (MPBC) is a rare and aggressive tumor type in great need of satisfactory therapies. Although most cases of MPBC are 'triple negative', they are nonetheless related to worse outcomes compared with other triple-negative invasive tumors. MPBC presents high levels of genetic and molecular heterogeneity, suggesting that novel targeted therapies can be exploited. Overexpression of PD-L1 and high levels of tumor-infiltrating lymphocytes have also been observed in these tumors, suggesting a role for immunotherapy. We present an updated literature revision on clinical, histopathological and molecular features of MPBC and their significance to prognosis and therapy options. We discuss emerging efforts to improve and personalize prognostic and therapeutic approaches, exploiting the molecular signature of MPBC with targeted therapies and immunotherapies.

Keywords: immunotherapy; metaplastic breast cancer; targeted therapy; triple-negative breast cancer.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast / immunology
  • Breast / pathology
  • Breast Neoplasms / genetics
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Chemotherapy, Adjuvant / methods
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Disease-Free Survival
  • Drug Resistance, Neoplasm / genetics
  • Female
  • Genetic Heterogeneity*
  • Humans
  • Immune Checkpoint Inhibitors / pharmacology
  • Immune Checkpoint Inhibitors / therapeutic use
  • Mastectomy / statistics & numerical data*
  • Neoadjuvant Therapy / methods
  • Neoadjuvant Therapy / statistics & numerical data
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / prevention & control
  • Prognosis
  • Tumor Microenvironment / genetics
  • Tumor Microenvironment / immunology

Substances

  • Immune Checkpoint Inhibitors