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Advanced Triple-Negative Breast Cancer — Systemic Therapy
First-line
Second-line
SECOND-LINE
Advanced TNBC
by PD-L1, gBRCA,
HER2 status
PD-L1+ (CPS ≥10)
gBRCA1/2
PD-L1 negative
HER2-low (IHC 1–2+)
TROP2 (any HER2)
First-line
Pembrolizumab + chemo
KEYNOTE-355 ↗
Targeted
PARP inhibitor (ola / tala)
OlympiAD ↗
First-line
Single-agent chemotherapy
no IO benefit
ADC
Trastuzumab deruxtecan
DESTINY-Breast04 ↗
ADC
Sacituzumab govitecan
ASCENT ↗