Synergistic Combinations for Improved Therapeutic Outcomes in Triple Negative Breast Cancer.

Abstract

Triple-negative breast cancer (TNBC) is a biologically aggressive and clinically challenging subtype of breast cancer, defined by the absence of hormone receptors and HER2 amplification. This limits the applicability of targeted therapies and contributes to poor prognosis. Emerging evidence underscores the therapeutic importance of rationally designed combination regimens capable of generating synergy by simultaneously engaging complementary oncogenic vulnerabilities. Synergistic combinations, such as dual blockade of PI3K/AKT and MAPK signalling, co-inhibition of DNA repair pathways (PARP with ATR or WEE1), and the integration of immune checkpoint inhibitors with chemotherapy, angiogenesis blockade, or epigenetic modifiers, enhance tumour control by disrupting adaptive resistance, promoting immunogenic cell death and remodelling the tumour microenvironment. These strategies exploit synthetic lethality and reverse immune exclusion, often yielding effects greater than the sum of individual agents. Increasing clinical evidence suggests that synergy-based therapeutic design may improve outcomes in TNBC by converting transient responses into durable remissions. Herein, we review the mechanistic insights and translational data that support synergy-driven polytherapy as a foundational paradigm in the evolving management of TNBC.